International Journal of Biomedical Engineering and Clinical Science

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Association Between the Distributions of Mean Corpuscular Hemoglobin and Red Blood Cell, and Mortality in a 3-Year Retrospective Study of Hemodialysis Patients

Received: 04 May 2020    Accepted: 15 June 2020    Published: 29 June 2020
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Abstract

Introduction: A red blood cell (RBC) concentration of 300 to 350×104/μL and mean corpuscular hemoglobin (MCH) concentration of 30 to 35 pg have been proposed as management target values from the relationship of Hb=RBC×MCH to control anemia, wherein Hb levels should not exceed 12 g/dL. In contrast, even in patients whose Hb levels are maintained at 10 to 12 g/dL, Hb levels are widely distributed when divided into RBC and MCH. Objective: We examined the prognosis in the distribution of MCH and RBC. Methods: Patients were classified into two groups based on MCH and RBC values, wherein patients with MCH≥30 pg but<35 pg and RBC≤350×104/μL (Group I, n=177); and MCH<30 pg and RBC>350×104/μL (Group II, n=217). Associations between all-cause mortality and the distributions of MCH and RBC as well as the iron profiles of these two groups were assessed by Kaplan-Meier curves and Cox proportional hazards regression model, respectively. Results: Patients with MCH<30 pg and RBC>350×104/μL (Group II, n=217) had an increased long-term risk of death and a higher rate of iron deficiency than patients with MCH≥30 pg but<35 pg and RBC≤350×104/μL (Group I, n=177). Conclusions: The management goal for renal anemia would be to control MCH within the range of 30−35 pg and RBC within the range of 300−350×104/μL, and to avoid absolute iron deficiency.

DOI 10.11648/j.ijbecs.20200602.13
Published in International Journal of Biomedical Engineering and Clinical Science (Volume 6, Issue 2, June 2020)
Page(s) 41-47
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Anemia Management, Hemodialysis, Hemoglobin, Mean Corpuscular Hemoglobin, Red Blood Cell

References
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[2] Yamamoto Y, Nishi S, Tomo T, Masakane I, Saito K, et al: 2015 Japanese Society for Dialysis Therapy: guidelines for renal anemia in chronic kidney disease. Renal Replacement Ther 2017; 3: 36.
[3] Daugirdas JT, Greene T, Depner TA, Chumlea C, Rocco MJ, Chertow GM, et al. Anthropometrically estimated total body water volumes are larger than modeled urea volume in chronic hemodialysis patients: effects of age, race, and gender. Kidney Int 2003 Sep; 64 (3): 1108-1119.
[4] Fishbane S, Berns JS. Hemoglobin cycling in hemodialysis patients treated with recombinant human erythropoietin. Kidney Int. 2005 Sep; 68 (3): 1337-43.
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[6] Hayashi T, Tanaka Y, Iwasaki M, Hase H, Yamamoto H, Komatsu Y, et al. Association of Circulatory Iron Deficiency With an Enlarged Heart in Patients With End-Stage Kidney Disease. J Ren Nutr. 2019 Jan; 29 (1): 39-47.
[7] Ogata H, Kumasawa J, Fukuma S, Mizobuchi M, Kinugasa E, Fukagawa M, et al. The cardiothoracic ratio and all-cause and cardiovascular disease mortality in patients undergoing maintenance hemodialysis: results of the MBD-5D study. Clin Exp Nephrol. 2017 Oct; 21 (5): 797-806.
[8] Yotsueda R, Taniguchi M, Tanaka S, Eriguchi M, Fujisaki K, Torisu K, et al. Cardiothoracic Ratio and All-Cause Mortality and Cardiovascular Disease Events in Hemodialysis Patients: The Q-Cohort Study. Am J Kidney Dis. 2017 Jul; 70 (1): 84-92.
[9] Koo HM, Kim CH, Doh FM, Lee MJ, Kim EJ, Han JH, et al. The relationship of initial transferrin saturation to cardiovascular parameters and outcomes in patients initiating dialysis. PLoS One. 2014 Feb 5; 9 (2): e87231.
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[11] Karaboyas A, Morgenstern H, Pisoni RL, Zee J, Vanholder R, Jacobson SH, et al. Association between serum ferritin and mortality: findings from the USA, Japan and European Dialysis Outcomes and Practice Patterns Study. Nephrol Dial Transplant. 2018 Dec; 33 (12): 2234-44.
[12] Kuragano T, Matsumura O, Matsuda A, Hara T, Kiyomoto H, Murata T, et al. Association between hemoglobin variability, serum ferritin levels, and adverse events/mortality in maintenance hemodialysis patients. Kidney Int. 2014 Oct; 86 (4): 845-54.
[13] Fukasawa H, Ishibuchi K, Kaneko M, Niwa H, Yasuda H, Kumagai H, et al. Red Blood Cell Distribution Width Is Associated With All-Cause and Cardiovascular Mortality in Hemodialysis Patients. Ther Apher Dial. 2017 Dec; 21 (6): 565-71.
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Author Information
  • Department of Medical Engineering, Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan

  • Department of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan

  • Department of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan

  • Graduate School of Applied Informatics, University of Hyogo, Kobe, Japan

  • Department of Nephrology, Tojinkai Satellite Clinic, Kyoto, Japan

  • Cardiovascular Division, Tojinkai Satellite Clinic, Kyoto, Japan

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    Yoshihiro Tsuji, Yasumasa Hitomi, Naoki Suzuki, Yuko Mizuno-Matsumoto, Toshiko Tokoro, et al. (2020). Association Between the Distributions of Mean Corpuscular Hemoglobin and Red Blood Cell, and Mortality in a 3-Year Retrospective Study of Hemodialysis Patients. International Journal of Biomedical Engineering and Clinical Science, 6(2), 41-47. https://doi.org/10.11648/j.ijbecs.20200602.13

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    ACS Style

    Yoshihiro Tsuji; Yasumasa Hitomi; Naoki Suzuki; Yuko Mizuno-Matsumoto; Toshiko Tokoro, et al. Association Between the Distributions of Mean Corpuscular Hemoglobin and Red Blood Cell, and Mortality in a 3-Year Retrospective Study of Hemodialysis Patients. Int. J. Biomed. Eng. Clin. Sci. 2020, 6(2), 41-47. doi: 10.11648/j.ijbecs.20200602.13

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    AMA Style

    Yoshihiro Tsuji, Yasumasa Hitomi, Naoki Suzuki, Yuko Mizuno-Matsumoto, Toshiko Tokoro, et al. Association Between the Distributions of Mean Corpuscular Hemoglobin and Red Blood Cell, and Mortality in a 3-Year Retrospective Study of Hemodialysis Patients. Int J Biomed Eng Clin Sci. 2020;6(2):41-47. doi: 10.11648/j.ijbecs.20200602.13

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  • @article{10.11648/j.ijbecs.20200602.13,
      author = {Yoshihiro Tsuji and Yasumasa Hitomi and Naoki Suzuki and Yuko Mizuno-Matsumoto and Toshiko Tokoro and Masato Nishimura},
      title = {Association Between the Distributions of Mean Corpuscular Hemoglobin and Red Blood Cell, and Mortality in a 3-Year Retrospective Study of Hemodialysis Patients},
      journal = {International Journal of Biomedical Engineering and Clinical Science},
      volume = {6},
      number = {2},
      pages = {41-47},
      doi = {10.11648/j.ijbecs.20200602.13},
      url = {https://doi.org/10.11648/j.ijbecs.20200602.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijbecs.20200602.13},
      abstract = {Introduction: A red blood cell (RBC) concentration of 300 to 350×104/μL and mean corpuscular hemoglobin (MCH) concentration of 30 to 35 pg have been proposed as management target values from the relationship of Hb=RBC×MCH to control anemia, wherein Hb levels should not exceed 12 g/dL. In contrast, even in patients whose Hb levels are maintained at 10 to 12 g/dL, Hb levels are widely distributed when divided into RBC and MCH. Objective: We examined the prognosis in the distribution of MCH and RBC. Methods: Patients were classified into two groups based on MCH and RBC values, wherein patients with MCH≥30 pg but4/μL (Group I, n=177); and MCH350×104/μL (Group II, n=217). Associations between all-cause mortality and the distributions of MCH and RBC as well as the iron profiles of these two groups were assessed by Kaplan-Meier curves and Cox proportional hazards regression model, respectively. Results: Patients with MCH350×104/μL (Group II, n=217) had an increased long-term risk of death and a higher rate of iron deficiency than patients with MCH≥30 pg but4/μL (Group I, n=177). Conclusions: The management goal for renal anemia would be to control MCH within the range of 30−35 pg and RBC within the range of 300−350×104/μL, and to avoid absolute iron deficiency.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Association Between the Distributions of Mean Corpuscular Hemoglobin and Red Blood Cell, and Mortality in a 3-Year Retrospective Study of Hemodialysis Patients
    AU  - Yoshihiro Tsuji
    AU  - Yasumasa Hitomi
    AU  - Naoki Suzuki
    AU  - Yuko Mizuno-Matsumoto
    AU  - Toshiko Tokoro
    AU  - Masato Nishimura
    Y1  - 2020/06/29
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ijbecs.20200602.13
    DO  - 10.11648/j.ijbecs.20200602.13
    T2  - International Journal of Biomedical Engineering and Clinical Science
    JF  - International Journal of Biomedical Engineering and Clinical Science
    JO  - International Journal of Biomedical Engineering and Clinical Science
    SP  - 41
    EP  - 47
    PB  - Science Publishing Group
    SN  - 2472-1301
    UR  - https://doi.org/10.11648/j.ijbecs.20200602.13
    AB  - Introduction: A red blood cell (RBC) concentration of 300 to 350×104/μL and mean corpuscular hemoglobin (MCH) concentration of 30 to 35 pg have been proposed as management target values from the relationship of Hb=RBC×MCH to control anemia, wherein Hb levels should not exceed 12 g/dL. In contrast, even in patients whose Hb levels are maintained at 10 to 12 g/dL, Hb levels are widely distributed when divided into RBC and MCH. Objective: We examined the prognosis in the distribution of MCH and RBC. Methods: Patients were classified into two groups based on MCH and RBC values, wherein patients with MCH≥30 pg but4/μL (Group I, n=177); and MCH350×104/μL (Group II, n=217). Associations between all-cause mortality and the distributions of MCH and RBC as well as the iron profiles of these two groups were assessed by Kaplan-Meier curves and Cox proportional hazards regression model, respectively. Results: Patients with MCH350×104/μL (Group II, n=217) had an increased long-term risk of death and a higher rate of iron deficiency than patients with MCH≥30 pg but4/μL (Group I, n=177). Conclusions: The management goal for renal anemia would be to control MCH within the range of 30−35 pg and RBC within the range of 300−350×104/μL, and to avoid absolute iron deficiency.
    VL  - 6
    IS  - 2
    ER  - 

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