The association of red blood cell parameters with mortality in a population of hemodialysis patients

BBACKGROUND AND OBJECTIVES

The targeting of higher hemoglobin levels leads to increased cardiovascular events in patients with renal disease. This study is an attempt to discover if changes in red blood cell parameters are induced by erythropoiesis-stimulating agents, and whether these changes are associated with mortality.

METHODS

A retrospective study of patients on hemodialysis at two dialysis units operated by Our Lady of Lourdes Hospital, Camden, N.J., evaluating the effect of dosage of epoetin alfa on red blood cell parameters and the relationship of these parameters with all cause mortality over the course of one year.

RESULTS

Dosage of epoetin alfa was related to red blood cell distribution width and mean corpuscular hemoglobin concentration in a statistically significant manner. Red blood cell distribution width was significantly lower in one year survivors. Quintile analysis demonstrated a relationship between red blood cell distribution width and iron saturation with one year survival. Low MCHC is a powerful predictor of short term mortality.

CONCLUSION

Mean corpuscular hemoglobin concentration and red blood cell distribution width are influenced by high doses of epoetin alfa. This study should serve to stimulate further investigation of the predictive role of red blood cell parameters in mortality in patients with renal disease and anemia treated with erythropoiesis stimulating agents, in an attempt to elucidate the mechanism of increased cardiovascular events in patients targeted to higher hemoglobin levels. Dial. Transplant. © 2011 Wiley Periodicals, Inc.