CBC

RDW Test

Also known as: Red Cell Distribution Width, RDW-CV, RDW-SD

What is RDW?

RDW (Red Cell Distribution Width) measures the variation in size of your red blood cells. Higher values mean more variation in cell sizes.[MedlinePlus (NIH)]

What This Test Measures

This test measures how much red blood cell sizes vary from the average. It is expressed as a coefficient of variation (RDW-CV) or standard deviation (RDW-SD).[Cleveland Clinic]

Why It's Important

  • RDW helps differentiate between types of anemia and can indicate mixed nutritional deficiencies.[MedlinePlus (NIH)]

  • Elevated RDW has been associated with increased risk of cardiovascular disease and mortality.[Cleveland Clinic]

Who Should Get This Test?

RDW is routinely measured as part of a complete blood count, especially when evaluating anemia.

Risk Factors

  • Symptoms of anemia (fatigue, weakness, shortness of breath)
  • Recent blood loss or surgery
  • Multiple nutritional deficiencies suspected
  • Chronic inflammatory conditions
  • Heart disease or heart failure
  • Receiving chemotherapy
  • History of blood transfusions
  • Unexplained fatigue with normal hemoglobin

Screening Schedule

Part of routine CBC; particularly useful when distinguishing between different causes of anemia.

Source: MedlinePlus (NIH)

What Happens During the Test

Blood Test

A blood sample is drawn from a vein. RDW is calculated automatically by the hematology analyzer based on the spread of red blood cell volumes.

Duration

5-10 minutes for blood draw; results typically available same day

Discomfort Level

Minimal discomfort from needle insertion

Source: Cleveland Clinic

Risks & Side Effects

Minimal Risk

Standard blood draw with minimal risks.

  • Brief pain at needle site
  • Small bruise may develop
  • Rare: lightheadedness
  • Very rare: infection at puncture site
Source: MedlinePlus (NIH)

Normal Range

RDW-CV: 11.5% to 14.5%. RDW-SD: 39 to 46 fL.

Note: Normal ranges may vary slightly between laboratories.

Source: MedlinePlus (NIH)

Unit Conversion

Convert between % (RDW-CV) and fL (RDW-SD)

RDW-SD (fL) = RDW-CV (%) × MCV (fL) / 100. Conversions require knowing MCV value.
% (RDW-CV)fL (RDW-SD)
1242
1345
1449
1552
1656
Source: Cleveland Clinic

High Values

High RDW indicates increased variation in red blood cell size (anisocytosis). Causes include iron deficiency, B12/folate deficiency, blood transfusion, and hemolytic anemia.[Cleveland Clinic]

Low Values

Low RDW is usually not clinically significant and indicates uniform red blood cell size.[MedlinePlus (NIH)]

Test Limitations & Accuracy

RDW interpretation has several considerations:

  • RDW can be elevated temporarily after blood transfusion
  • High reticulocyte counts increase RDW (young cells are larger)
  • Cold agglutinins can affect red cell volume measurement
  • Normal RDW does not rule out anemia
  • RDW changes lag behind hemoglobin in response to treatment
  • Some labs report RDW-CV (coefficient of variation) while others report RDW-SD (standard deviation)
  • RDW is nonspecific and elevated in many conditions
Source: Cleveland Clinic

Alternative & Complementary Tests

RDW is interpreted alongside other CBC components:

Combined with RDW to classify anemia type

Peripheral Blood Smear

To visually confirm variation in cell size (anisocytosis)

Reticulocyte Count

To assess bone marrow response to anemia

Iron Studies

When iron deficiency anemia suspected

When macrocytic anemia with high RDW

Source: MedlinePlus (NIH)

Frequently Asked Questions

What does high RDW indicate?

High RDW means your red blood cells vary significantly in size. This can indicate iron deficiency, vitamin deficiency, recent blood loss or transfusion, or bone marrow disorders. It helps doctors identify the cause of anemia.

Source: Cleveland Clinic

References

  1. 1.RDW (Red Cell Distribution Width)MedlinePlus (NIH)
  2. 2.RDW Blood TestCleveland Clinic

Related Condition Guides

Medical Disclaimer

This information is for educational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for interpretation of test results and medical decisions.

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