Recent studies have reported that high mean corpuscular volume (MCV) might be associated with mortality in patients with advanced chronic kidney disease (CKD). However, the question of whether a high MCV confers a risk for mortality in Japanese patients remains unclear. We conducted a longitudinal analysis of a cohort of 8571 patients using data derived from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS) phases 1 to 5. Associations of all-cause mortality, vascular events, and hospitalization due to infection with baseline MCV were examined via Cox proportional hazard models. Non-linear relationships between MCV and these outcomes were examined using restricted cubic spline analyses. Associations between time-varying MCV and these outcomes were also examined as sensitivity analyses. Cox proportional hazard models showed a significant association of low MCV (< 90 fL), but not for high MCV (102 < fL), with a higher incidence of all-cause mortality and hospitalization due to infection compared with 94 ≤ MCV < 98 fL (reference). Cubic spline analysis indicated a graphically U-shaped association between baseline MCV and all-cause mortality (p for non-linearity p < 0.001). In conclusion, a low rather than high MCV might be associated with increased risk for all-cause mortality and hospitalization due to infection among Japanese patients on hemodialysis.

最近的研究报告称，高平均红细胞体积（MCV）可能与晚期慢性肾病（CKD）患者的死亡率相关。然而，高 MCV 是否会带来日本患者死亡风险的问题仍不清楚。我们使用来自日本透析结果和实践模式研究 (J-DOPPS) 第 1 至 5 阶段的数据对 8571 名患者进行了纵向分析。全因死亡率、血管事件和感染所致住院与基线之间的关联MCV 通过 Cox 比例风险模型进行检查。使用限制三次样条分析检查 MCV 和这些结果之间的非线性关系。时变 MCV 与这些结果之间的关联也通过敏感性分析进行了检查。 Cox 比例风险模型显示低 MCV (< 90 fL) 存在显着关联，但与高 MCV (102 < fL) 无关，与 94 ≤ MCV < 98 fL 相比，全因死亡率和因感染而住院的发生率更高（参考）。三次样条分析表明基线 MCV 和全因死亡率之间呈 U 形关联（非线性 p < 0.001）。总之，低而不是高的 MCV 可能与日本血液透析患者感染导致的全因死亡率和住院风险增加相关。