Concordance between Reticulocyte Hemoglobin Equivalent and Reticulocyte Hemoglobin Content in CKD Patients Undergoing Hemodialysis.

AIM: to evaluate the correlation and the concordance between reticulocyte hemoglobin equivalent (RET-He) and reticulocyte hemoglobin content (CHr) as well as to obtain the cut-off value of RET-He as the target of iron supplementation in chronic kidney disease (CKD) patients undergoing hemodialysis. METHODS: a cross-sectional study was performed using K3EDTA-anticoagulated peripheral blood samples collected from 106 CKD patients undergoing routine hemodialysis. The samples were then analyzed using both Sysmex XN-2000 and Siemens ADVIA 2120i for RET-He and CHr analysis. RESULTS: a very strong correlation (r=0.91; p<0.0001) and a good concordance were found between RET-He and CHr with mean bias of 0.5 pg. The diagnostic concordance was 96.23%. The cut-off value of RET-He 29.2 pg was obtained from the receiver operating characteristic (ROC) curve with CHr as the gold standard. At this cut-off point, the sensitivity and specificity to assess the target of iron supplementation in CKD patients undergoing hemodialysis were 95.5% and 94%, respectively. CONCLUSION: the study shows a good correlation and concordance between RET-He and CHr in CKD patients undergoing hemodialysis.

Reticulocyte Indices for the Differential Diagnosis of Anemia of Chronic Disease and Iron Deficiency Anemia in Adult Women with Microcytic Hypochromic Anemia

BACKGROUND: Iron deficiency anemia (IDA) is the most common anemia followed by anemia of chronic disease (ACD). Reticulocyte indices have been shown to be helpful indicators for detecting IDA. We investigated whether RBC and reticulocyte indices can be used to differentiate ACD from IDA. METHODS: A total of 85 women showing microcytic hypochromic anemia (38 IDA and 47 ACD cases) were enrolled. IDA was defined as those with ferritin level of 450 microg/dL. ACD was defined as ferritin level of > or =6 microg/dL, TIBC of or =24.6 pg could be used to differentiate ACD from IDA with 85.1% sensitivity and 81.6% specificity. CONCLUSIONS: The reticulocyte indices, especially CHr, are useful for the differential diagnosis of microcytic hypochromic anemias, ACD and IDA.