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Abstract: TH-PO380

Mean Corpuscular Volume and Mortality in Peritoneal Dialysis

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Kalantar, Sara S., Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
  • Kleine, Carola-Ellen, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
  • Park, Christina, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
  • Hsiung, Jui-Ting, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
Background

Normocytic and normochromic anemia is a common sequela in chronic kidney disease, however some patients with end-stage renal disease present with macrocytic anemia. In hemodialysis patients abnormal mean corpuscular volume (MCV) was associated with mortality, while so far this association has not been explored in peritoneal dialysis (PD) patients.

Methods

We retrospectively examined a cohort of 14,251 incident PD patients from a large dialysis organization from 2007 to 2011 with MCV measurement within the first 91 days of PD treatment. PD patients were grouped into five a priori selected MCV categories. Using Cox models, we explored the association between baseline serum MCV and all-cause death with adjustments for case-mix variables and laboratory markers of malnutrition and inflammation (MICS).

Results

Mean age was 56±16 years and 43% of study participants were women. Higher MCV levels trended towards higher mortality across all levels of adjustment, although the association was attenuated after adjustment of case-mix and MICS variables. The highest MCV category (≥96 fL) was significantly associated with a higher risk of all-cause mortality when compared to the reference group (90-<93 fL) in the fully adjusted model (HR 1.29, 95%Cl 1.11-1.49). Lower MCV categories trended towards lower mortality. [figure1]

Conclusion

In incident PD patients, macrocytosis/higher MCV was associated with higher all-cause mortality risk. The underlying mechanisms of the observed MCV-mortality association remains unclear and should be explored in further studies.

Funding

  • NIDDK Support