Reticulocyte Haemoglobin as a Biomarker for the Detection of Iron Deficiency Anaemia in Haemodialysis Patients on Recombinant Human Erythropoietin
Keywords:
chronic kidney disease, haemodialysis, iron deficiency anaemia, recombinant human erythropoietin, reticulocyte haemoglobinAbstract
Iron deficiency anaemia (IDA) frequently occurs in haemodialysis (HD) patients undergoing recombinant human erythropoietin (rHuEPO) therapy and is commonly associated with rHuEPO hypo-responsiveness. However, the conventional iron indices are inadequate to exhibit the status or utilisation of iron during erythropoiesis. The aim of this study was to elucidate the accuracy and usefulness of the reticulocyte haemoglobin (RET-He) test for diagnosing IDA in HD patients undergoing rHuEPO therapy. Methods: In this cross-sectional study, fifty-five blood samples of HD patients on rHuEPO therapy were collected and analysed for haematological and biochemical parameters. A receiver operating characteristics curve was also plotted for sensitivity and specificity analysis. IDA detection rates by RET-He, soluble transferrin receptor (sTfR) and serum ferritin were 63.64%, 3.64% and 0%, respectively. RET-He level was significantly correlated with sTfR level, mean cell volume, mean cell haemoglobin level and the transferrin receptor-ferritin index. The sensitivity and specificity of RET-He in detecting IDA were 78.3% and 92.0%, respectively, with an area under the curve of 0.864. IDA was more frequently detected by RET-He than by ferritin or sTfR in HD patients undergoing rHuEPO therapy. The RET-He level also showed higher sensitivity and specificity for the iron status in these patients. Therefore, RET-He is a useful biomarker for the detection of IDA in HD patients undergoing rHuEPO therapy.
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