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Abstract: SA-PO940

Mean Corpuscular Volume Associates with Clinical Outcome in Incident Peritoneal Dialysis Patients

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Zhimin, Chen, Zhejiang University, Hang Zhou, China
  • Qureshi, Abdul Rashid Tony, Karolinska Institutet, Huddinge, STOCKHOLM, Sweden
  • Zhang, Xiaohui, Zhejiang University, Hangzhou, China
  • Han, Fei, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ZHEJIANG, China
  • Xie, Xishao, Kidney Disease Center, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China
  • Lindholm, Bengt, Karolinska Institutet, Huddinge, STOCKHOLM, Sweden
  • Stenvinkel, Peter, Karolinska University Hospital Huddinge, Stockholm, Sweden
  • Chen, Jianghua, Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ZHEJIANG, China
Background

Mean corpuscular volume (MCV), a measure of the average size of circulating erythrocytes, is used for differential diagnosis of anemia and for monitoring macrocytosis. While several studies revealed that MCV is associated with mortality in various clinical settings, it is unclear whether this association applies to PD patients. We investigated the relationship of MCV with all-cause and cardiovascular mortality in incident PD patients.

Methods

In 767 incident PD patients (median age 50 years, 57 % males, 15% diabetes, DM, and 6% cardiovascular disease, CVD), MCV andother metabolic biomarkers potentially linked to CVD were analysedat baseline. We investigated factors associated (Spearman correlations) with MCV at baseline and during follow up period of up to 60 monthswe analysed the association of MCV with mortality risk using competing-risk regression models with transplantation as competing risk and adjusting for covariates.

Results

In univariate analysis, MCV associated with white blood cell count (rho=-0.12, p=0.001), age (rho=0.15, p<0.001), BMI (rho=-0.15, p<0.001), gender (rho=-0.14, p=0.002), uric acid (rho=-0.15, p<0.001), HDL cholesterol (rho=0.10, p=0.005), parathyroid hormone (rho=0.12, p=0.001), ASAT (rho=0.12, p=0.001) and DM (rho=-0.09, p=0.01). Compared with middle+ high tertiles, the lowest tertile of MCV associated with decreased all-cause mortality risk, sub-hazard ratio (sHR) of 0.61 (95% CI, 0.42-0.89; p=0.01), and with decreased CVD mortality risk, sHR 0.50 (95% CI, 0.29-0.87; p=0.01) after adjusting for age, gender, DM, CVD and calendar year of recruitment.

Conclusion

In incident PD patients, after adjusting for age, sex, and presence of CVD and diabetes, low MCV was independently associated with decreased all-cause and CVD mortality risk. These results suggest that monitoring of MCV may provide useful prognostic information in patients treated with PD.