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
Volume 6, Issue 2, June 2020, Pages: 41-47
Received: May 4, 2020; Accepted: Jun. 15, 2020; Published: Jun. 29, 2020
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Yoshihiro Tsuji, Department of Medical Engineering, Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
Yasumasa Hitomi, Department of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan
Naoki Suzuki, Department of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan
Yuko Mizuno-Matsumoto, Graduate School of Applied Informatics, University of Hyogo, Kobe, Japan
Toshiko Tokoro, Department of Nephrology, Tojinkai Satellite Clinic, Kyoto, Japan
Masato Nishimura, Cardiovascular Division, Tojinkai Satellite Clinic, Kyoto, Japan
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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.
Anemia Management, Hemodialysis, Hemoglobin, Mean Corpuscular Hemoglobin, Red Blood Cell
To cite this article
Yoshihiro Tsuji, Yasumasa Hitomi, Naoki Suzuki, Yuko Mizuno-Matsumoto, Toshiko Tokoro, Masato Nishimura, 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. Vol. 6, No. 2, 2020, pp. 41-47. doi: 10.11648/j.ijbecs.20200602.13
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