Lu KL, Huang WH, Lu YA, et al. - In quest of a reliable predictor that facilitates early detection of infectious spondylitis (IS) in patients with end-stage renal disease (ESRD) under hemodialysis (HD), researchers performed this retrospective review and analyzed 12-year medical records from patients with ESRD under HD. In a 1:4 propensity score-matched case-control study, they compared 16 patients with IS with 64 controls for baseline features, underlying diseases, and laboratory data, one month prior to the date of diagnosis or the index date respectively. Significant predictors for a IS diagnosis one month later were: recent access operation, degenerative spinal disease, HD through a tunneled cuffed catheter, low serum levels of hemoglobin, albumin, as well as high levels of red blood cell volume distribution width (RDW), alkaline phosphatase (ALP), and high sensitivity C-reactive protein, as identified after adjustment. By further multivariate models, IS development may be indicated by both elevated serum ALP levels and low serum RDW levels after a recent access intervention in patients with relatively short HD vintages.