Importance of hemoglobin content in reticulocytes in the evaluation of iron status in hemodialysis patients

Introduction: Monitoring of iron is required in HD patients and is based on an assessment of three main factors: the determination of serum ferritin, transferrin saturation, and percentage of hypochromatic erythrocytes. Recent research highlights the importance of hemoglobin content in reticulocytes (CHr) as a sensitive and specific marker of iron deficiency in HD (HD) patients. Objective: To determine the value of CHr in chronic HD patients receiving erythropoietin and those who are on HD and continuous peritoneal dialysis, and who do not receive erythropoietin. The study included 53 patients at the Department of Nephrology, HD and Transplantation UKC in Tuzla. Results: The mean CHr in our study amounted to 33.92 +/- 3.52 pg for patients receiving erythropoietin and 32.32 +/- 4.66 pg for the group not receiving erythropoietin. Total 8/53 (15.1%) patients had CHr below 28 pg. Using the data obtained by ROC curve, a value of CHr with the best diagnostic performances, was 31.1 pg. Conclusion: Determination of CHr could be a reliable parameter of functional iron deficiency in patients on HD. So, the diagnosis of iron status would be more accurate, as well as the use of iron and erythropoietin.