Mean Corpuscular Volume and Mortality in Patients with CKD

Area of Science:

• Nephrology
• Hematology
• Clinical Epidemiology

Background:

• Mean corpuscular volume (MCV) measures average red blood cell size and is key in anemia diagnosis.
• Recent studies link MCV to mortality across various clinical settings.
• The association between MCV and mortality in chronic kidney disease (CKD) patients remains under-explored.

Purpose of the Study:

• To investigate the independent association between mean corpuscular volume (MCV) and mortality in patients with stages 3-5 CKD.
• To determine if MCV levels predict all-cause, cardiovascular, and infection-related mortality in this patient group.

Main Methods:

• Retrospective observational cohort study of 1439 patients with stages 3-5 CKD.
• Patients were stratified into high-MCV and low-MCV groups based on the median value (90.8 fl).
• Multivariate Cox regression analysis was used to examine the independent association of MCV with mortality.

Main Results:

• A total of 234 patients (16.2%) died during follow-up.
• The high-MCV group exhibited significantly higher crude mortality rates (22.7%) compared to the low-MCV group (9.7%).
• Fully adjusted models revealed that high MCV was associated with increased risks of all-cause (HR 2.19), cardiovascular (HR 3.57), and infection-related mortality (HR 2.22).

Conclusions:

• Mean corpuscular volume (MCV) is independently associated with all-cause, cardiovascular disease, and infection-associated mortality in patients with stages 3-5 CKD.
• Elevated MCV serves as a significant prognostic indicator in this population.
• Further research is warranted to elucidate the underlying pathophysiologic mechanisms linking MCV to mortality in CKD.