Low rather than high mean corpuscular volume is associated with mortality in Japanese patients under hemodialysis

Abstract

Recent studies have reported that high mean corpuscular volume (MCV) might be associated with mortality in patients with advanced chronic kidney disease (CKD). However, the question of whether a high MCV confers a risk for mortality in Japanese patients remains unclear. We conducted a longitudinal analysis of a cohort of 8571 patients using data derived from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS) phases 1 to 5. Associations of all-cause mortality, vascular events, and hospitalization due to infection with baseline MCV were examined via Cox proportional hazard models. Non-linear relationships between MCV and these outcomes were examined using restricted cubic spline analyses. Associations between time-varying MCV and these outcomes were also examined as sensitivity analyses. Cox proportional hazard models showed a significant association of low MCV (< 90 fL), but not for high MCV (102 < fL), with a higher incidence of all-cause mortality and hospitalization due to infection compared with 94 ≤ MCV < 98 fL (reference). Cubic spline analysis indicated a graphically U-shaped association between baseline MCV and all-cause mortality (p for non-linearity p < 0.001). In conclusion, a low rather than high MCV might be associated with increased risk for all-cause mortality and hospitalization due to infection among Japanese patients on hemodialysis.

The Effects of Therapeutic Intermittent Hypoxia Implementation on Complete Blood Count Parameters: An Experimental Animal Model

“…MCH refers to the amount of hemoglobin per erythrocyte, and low-level MCH has been found to be strongly associated with intensive care admission due to myocardial infarction (17). In a study, low level MCH was found to be highly correlated with mortality rate, and a significant relationship was pointed out between very high level of MCH and mortality (18). In our study, in terms of the CBC analysis, there was no significant difference in hemoglobin and hematocrit levels between the two groups, but it was found that MCH increased significantly in the study group (p=0.03).…”

Prevalence and Predictors of Aortic Valve Sclerosis in Chronic Hemodialysis Patients Walid Ahmed Ragab Abdelhamid

“…This is inconsistent with the results obtained in the general population by Vezzoli et al (15) . This can be explained by the fact that low red cell indices are very common in CKD patients and they result mainly from chronic inflammation and insufficiency of iron (16) . The reduced levels of MCV and MCH are closely related to the deficiency of Klotho (17) .…”

Prognostic value of red cell distribution width and mean corpuscular volume on mortality in hemodialysis patients

“…21 A larger cohort study including 109,501 incident HD patients showed MCV > 100 fl was associated with both CV and infectious mortality. 9 However, Sun et al 22 and Honda et al 10 reported a low MCV to be a risk factor for poor survival in patients receiving elective percutaneous coronary intervention and HD. In this study, we found HD patients with an elevated RDW and MCV level were suffered with a higher risk for all-cause mortality in an unadjusted model.…”

“…9 However, another longitudinal analysis drew a conclusion that lower level of MCV was significantly associated with a higher incidence of all-cause mortality in HD patients. 10 Although the variability in RBC size seems to be novel risk factors for poor prognosis, the relationship between MCV and mortality is still controversial. And we would like to definie the effect of the combination of RDW and MCV on mortality in maintenance HD patients in this study.…”

“…At the same time, higher MCV value could also serve as a risk factor for all‐cause and CV mortality in CKD 8 and HD patients 9 . However, another longitudinal analysis drew a conclusion that lower level of MCV was significantly associated with a higher incidence of all‐cause mortality in HD patients 10 …”