PMID- 34213761
OWN - NLM
STAT- MEDLINE
DCOM- 20220323
LR  - 20220323
IS  - 1724-6059 (Electronic)
IS  - 1121-8428 (Linking)
VI  - 35
IP  - 2
DP  - 2022 Mar
TI  - Mean corpuscular hemoglobin concentration: an anemia parameter predicting 
      cardiovascular disease in incident dialysis patients.
PG  - 535-544
LID - 10.1007/s40620-021-01107-w [doi]
AB  - BACKGROUND: Hemoglobin levels usually decline before dialysis initiation. The 
      influence of overhydration on anemia progression and iron sequestration is poorly 
      documented. Furthermore, clinical implications of anemia at dialysis initiation 
      remain to be elucidated. METHODS: This multicenter retrospective cohort study 
      enrolled incident dialysis patients. The patients were stratified by tertiles of 
      overhydration rate (OH-R) defined by (BW - DW)/DW*100 (BW: body weight just 
      before dialysis initiation, DW: dry weight). Time courses (6 months before, to 
      1 month after, dialysis initiation) of hemoglobin, C-reactive protein (CRP), and 
      iron sequestration index (ISI) were examined using mixed effects models. We used 
      Cox models to identify anemia parameters predicting subsequent cardiovascular 
      disease (CVD). RESULTS: Among the 905 enrolled patients, hemoglobin levels 
      gradually decreased before dialysis initiation and rapidly increased thereafter. 
      An inverse V-shaped time course was observed for CRP and ISI with an increase 
      during dialysis initiation. Patients with a higher OH-R showed lower hemoglobin 
      levels along with higher CRP and ISI levels before dialysis initiation. Mean 
      corpuscular hemoglobin concentration (MCHC) was more stable before dialysis 
      initiation than were mean corpuscular volume (MCV) and mean corpuscular 
      hemoglobin (MCH). Low MCHC (< 32 g/dL) was independently associated with the 
      incidence of nonatherosclerotic CVD. Patients with low MCHC tended to have 
      increased left ventricular wall thickness and left atrial diameter. CONCLUSIONS: 
      Progression of anemia before dialysis among overhydrated patients may mainly 
      occur through hemodilution and iron sequestration partly induced by inflammation. 
      Low MCHC reflects left atrial overload and left ventricular hypertrophy and hence 
      may predict nonatherosclerotic CVD.
CI  - (c) 2021. Italian Society of Nephrology.
FAU - Yamaguchi, Satoshi
AU  - Yamaguchi S
AD  - Department of Nephrology, Osaka University Graduate School of Medicine, Suita, 
      Osaka, Japan.
AD  - Department of Internal Medicine, Japan Community Health care Organization Osaka 
      Hospital, Osaka, Japan.
FAU - Hamano, Takayuki
AU  - Hamano T
AUID- ORCID: 0000-0002-2100-9106
AD  - Department of Nephrology, Osaka University Graduate School of Medicine, Suita, 
      Osaka, Japan. hamatea@med.nagoya-cu.ac.jp.
AD  - Department of Nephrology, Nagoya City University Graduate School of Medical 
      Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8602, Japan. 
      hamatea@med.nagoya-cu.ac.jp.
FAU - Oka, Tatsufumi
AU  - Oka T
AD  - Department of Nephrology, Osaka University Graduate School of Medicine, Suita, 
      Osaka, Japan.
FAU - Doi, Yohei
AU  - Doi Y
AD  - Department of Nephrology, Osaka University Graduate School of Medicine, Suita, 
      Osaka, Japan.
FAU - Kajimoto, Sachio
AU  - Kajimoto S
AD  - Department of Nephrology, Osaka University Graduate School of Medicine, Suita, 
      Osaka, Japan.
FAU - Shimada, Karin
AU  - Shimada K
AD  - Department of Nephrology, Osaka University Graduate School of Medicine, Suita, 
      Osaka, Japan.
FAU - Matsumoto, Ayumi
AU  - Matsumoto A
AD  - Department of Nephrology, Osaka University Graduate School of Medicine, Suita, 
      Osaka, Japan.
FAU - Sakaguchi, Yusuke
AU  - Sakaguchi Y
AD  - Department of Inter-Organ Communication Research in Kidney Disease, Osaka 
      University Graduate School of Medicine, Suita, Osaka, Japan.
FAU - Matsui, Isao
AU  - Matsui I
AD  - Department of Nephrology, Osaka University Graduate School of Medicine, Suita, 
      Osaka, Japan.
FAU - Suzuki, Akira
AU  - Suzuki A
AD  - Department of Internal Medicine, Japan Community Health care Organization Osaka 
      Hospital, Osaka, Japan.
FAU - Isaka, Yoshitaka
AU  - Isaka Y
AD  - Department of Nephrology, Osaka University Graduate School of Medicine, Suita, 
      Osaka, Japan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20210702
PL  - Italy
TA  - J Nephrol
JT  - Journal of nephrology
JID - 9012268
SB  - IM
MH  - *Anemia/diagnosis/epidemiology/etiology
MH  - *Cardiovascular Diseases/diagnosis/epidemiology/etiology
MH  - Erythrocyte Indices
MH  - Humans
MH  - Renal Dialysis/adverse effects
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Cardiovascular disease
OT  - Hemodilution
OT  - Hemoglobin dip
OT  - Iron sequestration
EDAT- 2021/07/03 06:00
MHDA- 2022/03/24 06:00
CRDT- 2021/07/02 12:24
PHST- 2021/01/30 00:00 [received]
PHST- 2021/06/21 00:00 [accepted]
PHST- 2021/07/03 06:00 [pubmed]
PHST- 2022/03/24 06:00 [medline]
PHST- 2021/07/02 12:24 [entrez]
AID - 10.1007/s40620-021-01107-w [pii]
AID - 10.1007/s40620-021-01107-w [doi]
PST - ppublish
SO  - J Nephrol. 2022 Mar;35(2):535-544. doi: 10.1007/s40620-021-01107-w. Epub 2021 Jul 
      2.