Relationship between red cell distribution width, mean corpuscular hemoglobin level, and the treatment of renal anemia in hemodialysis patients

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  • 血液透析患者における赤血球容積分布幅（RDW），平均赤血球ヘモグロビン量（MCH）と腎性貧血治療との関連性
  • ケツエキ トウセキ カンジャ ニ オケル セッケッキュウ ヨウセキ ブン ヌノハバ(RDW),ヘイキン セッケッキュウ ヘモグロビンリョウ(MCH)ト ジンセイ ヒンケツ チリョウ ト ノ カンレンセイ

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<p>［Objectives］This study aimed to evaluate the relationships among the red cell distribution width (RDW), the mean corpuscular hemoglobin (MCH) level, and the treatment of renal anemia in hemodialysis (HD) patients.［Subjects］The subjects were 926 patients who were receiving maintenance HD and an erythropoiesis‒stimulating agent (ESA).［Methods］①We divided the HD patients into two groups based on the median RDW and compared the results. Then, we performed multiple regression analysis using RDW as the objective variable. ②We grouped the patients according to their red blood cell (RBC) counts and MCH levels and then compared their ESA dosages and other factors. ③We divided the patients into iron‒deficient and ‒sufficient groups, based on their ferritin and transferrin saturation values, and then compared their ESA dosages and other factors. ④We compared the effects of oral and intravenously administered iron agents.［Results］The HD patients with lower MCH levels had higher RDW values and required higher ESA dosages. The ESA dosage and MCH level were considered to significantly influence the RDW. Patients with MCH levels of ＜30 pg had higher RDW values and needed higher ESA dosages. Furthermore, the patients using oral iron agents had lower RDW values and ESA dosages.［Conclusions］HD patients with higher RDW values and lower MCH levels develop RBC iron deficiency and require higher ESA dosages. In order to reduce the ESA dosages required to effectively treat renal anemia, the MCH level can be used as an indicator of the requirement for iron agent treatment.</p>

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