title: Diagnosis of iron deficiency in patients undergoing hemodialysis.
abstract: To diagnose iron deficiency in patients undergoing hemodialysis, the percentage of hypochromic RBCs (with cellular hemoglobin concentration <280 g/L [HYPO%]) and mean reticulocyte hemoglobin content (CHret) provided by the Siemens ADVIA 120 and 2120 analyzers (Siemens Diagnostic Solutions, Tarrytown, NY) were proposed as alternatives to biochemical tests. Sysmex, with its XE-5000 analyzer (Sysmex, Kobe, Japan), also proposed the percentage of erythrocytes with cellular hemoglobin content lower than 17 pg (%Hypo-He) and equivalent of the mean reticulocyte hemoglobin content (Ret-He) with similar clinical applications. Our aim was to verify the clinical usefulness of the biochemical and cellular parameters as predictors of iron deficiency in patients undergoing long-term hemodialysis. We studied 69 patients undergoing hemodialysis 3 times weekly. The baseline values of serum ferritin and percentage of transferrin saturation were poor predictors of iron responsiveness. Better ability was demonstrated by reticulocyte indices (area under the curve [AUC], 0.74 for CHret and 0.72 for Ret-He; best cutoff values, 31.2 and 30.6 pg, respectively) and erythrocyte parameters (AUC, 0.72 for HYPO% and 0.68 for %Hypo-He; best cutoff values, 5.8 and 2.7, respectively). The newly proposed Ret-He and %Hypo-He can provide clinicians with information equivalent to CHret and HYPO%.
authors.affiliation: Dept. of Laboratory Medicine, University Hospital of Padova, Via Giustiniani, Padua, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Buttarello
authors.forename: Rachele
authors.initials: R
authors.lastname: Pajola
authors.forename: Enrica
authors.initials: E
authors.lastname: Novello
authors.forename: Mirca
authors.initials: M
authors.lastname: Rebeschini
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cantaro
authors.forename: Fausto
authors.initials: F
authors.lastname: Oliosi
authors.forename: Agostino
authors.initials: A
authors.lastname: Naso
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D004912:Erythrocytes / Q000737:chemistry*; D005293:Ferritins / Q000032:analysis; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000097:blood / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000097:blood; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000009:adverse effects*; D012156:Reticulocytes / Q000737:chemistry*; D014168:Transferrin / Q000032:analysis
chemical_list: D006454:Hemoglobins; D014168:Transferrin; D005293:Ferritins; D007501:Iron