Evidence map›Paper›PMID 40443639›Full record

ArticleCureus2025

Mean Corpuscular Volume Is Not a Reliable Predictor of Iron Deficiency in Patients With Chronic Kidney Disease: A Post-Hoc Analysis of the BRIGHTEN Trial.

Sayaka Shimizu, Tatsuo Kagimura, Shoichi Maruyama, Ichiei Narita

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Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Sayaka ShimizuDepartment of Research, Patient Driven Academic League (PeDAL), Kyoto, JPN.
Tatsuo KagimuraTranslational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, JPN.
Shoichi MaruyamaDepartment of Nephrology, Nagoya University, Aichi, JPN.
Ichiei NaritaDivision of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, JPN.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction Timely diagnosis of iron deficiency is crucial for managing anemia in patients with non-dialysis-dependent chronic kidney disease (ND-CKD). However, iron status results are not always immediately available. We aimed to examine the performance of mean corpuscular volume (MCV) in diagnosing iron deficiency as a primary objective and of iron status in predicting the onset of iron deficiency as a secondary objective. Methods This retrospective cohort study included adult patients with ND-CKD from the BRIGHTEN (oBservational clinical Research In chronic kidney disease patients with renal anemia: renal proGnosis in patients with Hyporesponsive anemia To Erythropoiesis-stimulating agents, darbepoetiN alfa) trial (enrolled from June 2014 to September 2016) in Japan who were started on darbepoetin-alpha for renal anemia and patients who were not started on iron supplementation during weeks 0-24. Diagnostic performance analysis assessed the MCV at week 24 and changes in MCV from week 12 to 24 for diagnosing iron deficiency (ferritin < 100 ng/mL) at week 24, using receiver operating characteristic curves, area under the curve (AUC), sensitivity, and specificity. For the patients without iron deficiency at week 12, ferritin levels at week 12 were assessed by predictive performance analysis to predict new-onset iron deficiency at week 24. Results A total of 796 participants were included in the diagnostic performance analysis (mean age, 70.0 years; mean estimated glomerular filtration rate, 19.2 mL/min/1.73 m²), and 338 were included in the predictive performance analysis. Diagnostic performance analysis revealed an AUC for MCV of 0.55 (95% confidence interval (CI), 0.51-0.59); for MCV changes, it was 0.52 (95% CI, 0.48-0.57). Prognostic performance analysis revealed that ferritin at week 12 demonstrated an AUC of 0.77 (95% CI, 0.67-0.86), with a sensitivity of 83% and a specificity of 66% at a cutoff of 131.5 ng/mL. Conclusion Neither MCV nor the changes in MCV could reliably diagnose iron deficiency in patients with ND-CKD. Ferritin level < 130 ng/mL could predict new-onset iron deficiency within 12 weeks.

Indexed as

anemiadiagnosisiron-binding proteinsiron deficiencyprognosisrenal insufficiency

Identifiers

PMID40443639
PMCPMC12120319

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.