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Mean corpuscular volume is associated with endothelial dysfunction and predicts composite cardiovascular events in patients with chronic kidney disease
Author(s) -
Solak Yalcin,
Yilmaz Mahmut Ilker,
Saglam Mutlu,
Demirbas Seref,
Verim Samet,
Unal Hilmi Umut,
Gaipov Abduzhappar,
Oguz Yusuf,
Kayrak Mehmet,
Caglar Kayser,
Vural Abdulgaffar,
Turk Suleyman,
Covic Adrian,
Kanbay Mehmet
Publication year - 2013
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12130
Subject(s) - medicine , mean corpuscular volume , kidney disease , renal function , proportional hazards model , gastroenterology , confounding , diabetes mellitus , hematocrit , endocrinology
Aim Mean corpuscular volume ( MCV ) is a measure of size of red blood cells. Recently a few studies showed an association of macrocytosis with all‐cause mortality. We aimed to assess the relationship of MCV with cardiovascular ( CV ) morbidity and mortality in patients with chronic kidney disease ( CKD ), and the effect of MCV on endothelial function. Methods This is an observational cohort study with a prospectively maintained cohort of patients with stage 1–5 CKD . Estimated glomerular filtration rate ( eGFR ), flow mediated dilatation ( FMD ) and laboratory values were measured at baseline. Multivariate linear and Cox regression analyses were used to predict independent associations of FMD and composite CV events, respectively. Results A total of 309 patients were included in the study. In contrast to anaemia MCV did not show a significant change among CKD groups. MCV was an independent predictor of FMD in addition to serum haemoglobin, CRP , diabetes, systolic blood pressure ( SBP ) and eGFR . Median MCV value was 85 fl. K aplan– M eier analysis showed that at 38 months the survival rate was 97.6% in the group with MCV < 85 compared to 81.6% in the arm with MCV ≥ 85 ( P < 0.001, log‐rank test). Cox regression analysis showed MCV as a predictor of composite CV events independent of major confounding factors. Conclusion This is the first study in the literature showing an independent association of MCV and FMD . Our results also determined MCV as an independent predictor of composite CV events independent of anaemia, inflammation, diabetes and eGFR in patients with CKD .