High Mean Corpuscular Volume Ups Hemodialysis Patient Death Risk

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Study of 109,501 incidental HD patients reveals an association between high mean corpuscular volume and increased risk of all-cause, cardiovascular, and infection-related mortality.
Study of 109,501 incidental HD patients reveals an association between high mean corpuscular volume and increased risk of all-cause, cardiovascular, and infection-related mortality.

AUSTIN, Texas—High mean corpuscular volume (MCV) in patients on hemodialysis (HD) is associated with higher risks of death from any cause, as well as from cardiovascular and infectious causes, investigators reported at the National Kidney Foundation's 2018 Spring Clinical Meetings.

In a retrospective observational cohort study that included 109,501 incident HD patients, a team led by Kamyar Kalantar-Zadeh, MD, PhD, of the University of California Irvine School of Medicine, found that, compared with patients who had a baseline MCV value of 92 to less than 94 fl (reference), patients with a baseline MCV of 100 fl or higher had a significant 28% increased risk of all-cause mortality, 27% increased risk of cardiovascular (CV) mortality, and 18% increased risk of infection-related mortality, in a fully adjusted model.

Adjustment for malnutrition-inflammation complex syndrome variables partially attenuated the associations.

The new findings build on those from a recent study published in the Clinical Journal of the American Society of Nephrology (2017;12:237-244) demonstrating an association between elevated MCV and all-cause, CV, and infection-related mortality among patients with stage 3–5 chronic kidney disease. In that study, patients with an MCV of 90.8 fl (the median value of MCV) or above, those with an MCV less than 90.8 fl had a 2-fold increased risk of all-cause and infection-related mortality and a 3.6-fold increased risk of CV mortality in a fully-adjusted model.

References

Dratch A, Kleine CE, Rhee CM, et al. Mean corpuscular volume and mortality in incident hemodialysis patients. Data presented in poster format at the National Kidney Foundation's 2018 Spring Clinical Meetings in Austin, Texas, April 10–14. Poster 150.

Hsieh YP, Chang CC, Kor CT, et al. Mean corpuscular volume and mortality in patients with CKD. Clin J Am Soc Nephrol. 2017;12:237-244).

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