High Mean Corpuscular Volume Ups Death Risk in PD Patients
Peritoneal dialysis patients with MCV of 96 fl or more had a 29% greater risk for early death compared with a reference group.
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SAN DIEGO—Peritoneal dialysis (PD) patients with macrocytosis have a higher risk of dying prematurely than those without the condition, researchers reported at the American Society of Nephrology's Kidney Week 2018 conference.
Previous research has shown that hemodialysis patients with abnormal mean corpuscular volume (MCV) have higher mortality.
Elani Streja, MPH, PhD, of the University of California Irvine, and colleagues studied the association in 14,251 new PD patients (mean age 56 years; 43% women; 60% white with baseline measurements of serum MCV grouped into quintiles. According to Cox models, PD patients with higher MCV levels had higher risks for all-cause mortality. The relationship was attenuated after adjustment for case-mix variables and laboratory markers of malnutrition and inflammation. In a fully adjusted model, PD patients in the highest MCV category (96 fl or more) had a 29% greater risk for early death compared with the reference group (90 or higher but less than less than 93 fl).
“These data suggest that mean corpuscular volume may be used as an important marker of morbidity and a potential predictor of dialysis outcomes in PD patients,” Dr Streja told Renal & Urology News. “Whether MCV can serve as a better metric and predictor of survival in PD patients than conventional indices warrants additional investigation. We're planning to further explore these associations in time-varying models and with evaluations of potential effect modification by medication use, race, age, and comorbidity.”
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Kalantar S, Kleine CE, Park C, et al. Mean corpuscular volume and mortality in peritoneal dialysis. Presented at the American Society of Nephrology's Kidney Week 2018 conference in San Diego, Oct. 23-28. Poster TH-PO380.