Mean corpuscular volume is associated with endothelial dysfunction and predicts composite cardiovascular events in patients with chronic kidney disease

Yalcin Solak, Mahmut Ilker Yilmaz, Mutlu Saglam, Seref Demirbas, Samet Verim, Hilmi Umut Unal, Abduzhappar Gaipov, Yusuf Oguz, Mehmet Kayrak, Kayser Caglar, Abdulgaffar Vural, Suleyman Turk, Adrian Covic, Mehmet Kanbay

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19 Citations (Scopus)

Abstract

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. Kaplan-Meier 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. Summary at a Glance In CKD patients, this study clearly demonstrated that the mean corpuscular volume (MCV) is independently associated with composite cardiovascular events as well as flow mediated dilatation.

Original languageEnglish
Pages (from-to)728-735
Number of pages8
JournalNephrology
Volume18
Issue number11
DOIs
Publication statusPublished - Jan 1 2013
Externally publishedYes

Keywords

  • cardiovascular event
  • chronic kidney disease
  • flow mediated dilatation
  • mean corpuscular volume
  • prediction

ASJC Scopus subject areas

  • Nephrology

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    Solak, Y., Yilmaz, M. I., Saglam, M., Demirbas, S., Verim, S., Unal, H. U., Gaipov, A., Oguz, Y., Kayrak, M., Caglar, K., Vural, A., Turk, S., Covic, A., & Kanbay, M. (2013). Mean corpuscular volume is associated with endothelial dysfunction and predicts composite cardiovascular events in patients with chronic kidney disease. Nephrology, 18(11), 728-735. https://doi.org/10.1111/nep.12130