Discrepancy between the percentage of hypochromic erythrocytes and the reticulocyte hemoglobin content in hemodialysis patients with recombinant human erythropoietin therapy.
The percentage of hypochromic erythrocytes (%HYPO) and the reticulocyte hemoglobin content (CHr) have been used for the diagnosis of iron deficiency (ID). However, we found a discrepancy between %HYPO and CHr values in some hemodialysis patients. Hemodialysis patients receiving recombinant human erythropoietin (rHuEPO) with ID were defined as patients with a %HYPO value exceeding 5%. Five ID patients with a high CHr (group A) and 3 ID patients with a low CHr (group B) received 120 mg/week iron intravenously for 8 to 12 weeks. Changes in %HYPO, CHr, percentage of macrocytic erythrocytes (%MACRO), absolute reticulocyte count, immature reticulocyte fraction, and soluble transferrin receptor level were investigated over a 20-week period. CHrs were measured with 2 hematology analyzers: the Bayer HealthCare Technicon H*3 and the ADVIA 120. Patients in group A showed a significantly greater mean %MACRO (P < .01) and a lower mean red blood cell number (P < .05) than patients in group B. Even the mean CHr at baseline in group A was significantly higher than the mean CHr in the healthy subjects (P < .01), and hemoglobin levels increased in association with the reduction in rHuEPO dose following iron administration (P < .01). We found a group with high CHr, %HYPO, and %MACRO values among hemodialysis patients. Iron administration enables the rHuEPO dose to be reduced.
Asanuma
Masae
M
Department of Clinical Laboratory, Internal Medicine, San-ai Hospital, 1-31-31 Tsukigaoka, Morioka, Iwate, Japan. cl-sanai@iwate.email.ne.jp
Taguchi
Chie
C
Uesaka
Hiroko
H
Kumagai
Toshiko
T
Seino
Koji
K
Hosokawa
Hisaaki
H
Yamauchi
Fumitoshi
F
Fujishima
Mikihiko
M
Murai
Kazunori
K
Ishida
Yoji
Y
D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000188:drug therapy; D016022:Case-Control Studies; D016903:Drug Monitoring / Q000379:methods; D004912:Erythrocytes / Q000473:pathology*; D004921:Erythropoietin / Q000627:therapeutic use*; D006403:Hematologic Tests; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007501:Iron / Q000008:administration & dosage; D011994:Recombinant Proteins; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000097:blood / Q000188:drug therapy; D012156:Reticulocytes / Q000737:chemistry / Q000473:pathology*
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D007501:Iron