Clinical usefulness of the reticulocyte hemoglobin in chronic hemodialysis patients
Background. Iron deficiency is the main cause of failure to respond to erythropoietin (EPO) in haemodialysis patients. Several laboratory tests to detect the deficiency, ferritin and transferrin saturation (TSat) are the most commonly used but its limitations in this patient population are necessary...
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| Formato: | Artículo revista |
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Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2011
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/21535 |
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I10-R10-article-21535 |
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Universidad Nacional de Córdoba |
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Revistas de la UNC |
| language |
Español |
| format |
Artículo revista |
| topic |
deficiencia de hierro hemoglobina reticulocitaria equivalente hemodiálisis eritropoyetina saturación de transferrina iron deficiency reticulocyte hemoglobin equivalent haemodialysis erythropoietin transferring saturation |
| spellingShingle |
deficiencia de hierro hemoglobina reticulocitaria equivalente hemodiálisis eritropoyetina saturación de transferrina iron deficiency reticulocyte hemoglobin equivalent haemodialysis erythropoietin transferring saturation Eckhardt, Andrea Freiberg, M. De la Fuente, Jorge Luis Douthat, Walter G. Capra, Raúl Horacio Clinical usefulness of the reticulocyte hemoglobin in chronic hemodialysis patients |
| topic_facet |
deficiencia de hierro hemoglobina reticulocitaria equivalente hemodiálisis eritropoyetina saturación de transferrina iron deficiency reticulocyte hemoglobin equivalent haemodialysis erythropoietin transferring saturation |
| author |
Eckhardt, Andrea Freiberg, M. De la Fuente, Jorge Luis Douthat, Walter G. Capra, Raúl Horacio |
| author_facet |
Eckhardt, Andrea Freiberg, M. De la Fuente, Jorge Luis Douthat, Walter G. Capra, Raúl Horacio |
| author_sort |
Eckhardt, Andrea |
| title |
Clinical usefulness of the reticulocyte hemoglobin in chronic hemodialysis patients |
| title_short |
Clinical usefulness of the reticulocyte hemoglobin in chronic hemodialysis patients |
| title_full |
Clinical usefulness of the reticulocyte hemoglobin in chronic hemodialysis patients |
| title_fullStr |
Clinical usefulness of the reticulocyte hemoglobin in chronic hemodialysis patients |
| title_full_unstemmed |
Clinical usefulness of the reticulocyte hemoglobin in chronic hemodialysis patients |
| title_sort |
clinical usefulness of the reticulocyte hemoglobin in chronic hemodialysis patients |
| description |
Background. Iron deficiency is the main cause of failure to respond to erythropoietin (EPO) in haemodialysis patients. Several laboratory tests to detect the deficiency, ferritin and transferrin saturation (TSat) are the most commonly used but its limitations in this patient population are necessary to find other parameters to improve the identification of iron-deficient state. Objective. To evaluate the ability of Reticulocyte Hemoglobin Equivalent (RET-He) to predict iron deficiency, taking as a reference standard to the increase of hemoglobin in response to iron intake. Materials and Methods. 44 patients on chronic hemodialysis and fixed-dose EPO received 400 mg of intravenous iron. Were measured Hb, Ret-He, IRF, and ferritin prior to iron administration. After 20 to 30 days of completion of loading the patients were classified as responders if hemoglobin increased by at least 0.8 g / L and non-responders if this increase did not occur. Result. 25 patients were reponders, the ROC curves analysis showed the Ret-He with the largest AUC of 0.862 similar to the AUC of 0.833 that showed the IST, but the first is more sensitive (72% CI 95%: 51-88% vs 52% 95% CI 31-72%) and similar specificity (94.7% CI 95%: 74-100% vs 100% 95% CI 82-100%). Ferritin AUC was 0.772 and finally the IRF AUC was 0.7. The Ret-He, to a cutoff of 29.5 pg was the best combination of sensitivity and specificity (72 and 94.7 respectively), and the sensitivity of the combination Ret-He/IST rose to 80% specificity 94.7%. Conclusions. According to these results it could consider to Ret-He and the Ret-He/IST combination of clinical utility for the identification of the iron deficit in patients in chronic haemodialysis. |
| publisher |
Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2011 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/21535 |
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I10-R10-article-215352019-05-20T10:49:17Z Clinical usefulness of the reticulocyte hemoglobin in chronic hemodialysis patients Utilidad clínica de la hemoglobina reticulocitaria equivalente en pacientes en hemodialisis crónica Eckhardt, Andrea Freiberg, M. De la Fuente, Jorge Luis Douthat, Walter G. Capra, Raúl Horacio deficiencia de hierro hemoglobina reticulocitaria equivalente hemodiálisis eritropoyetina saturación de transferrina iron deficiency reticulocyte hemoglobin equivalent haemodialysis erythropoietin transferring saturation Background. Iron deficiency is the main cause of failure to respond to erythropoietin (EPO) in haemodialysis patients. Several laboratory tests to detect the deficiency, ferritin and transferrin saturation (TSat) are the most commonly used but its limitations in this patient population are necessary to find other parameters to improve the identification of iron-deficient state. Objective. To evaluate the ability of Reticulocyte Hemoglobin Equivalent (RET-He) to predict iron deficiency, taking as a reference standard to the increase of hemoglobin in response to iron intake. Materials and Methods. 44 patients on chronic hemodialysis and fixed-dose EPO received 400 mg of intravenous iron. Were measured Hb, Ret-He, IRF, and ferritin prior to iron administration. After 20 to 30 days of completion of loading the patients were classified as responders if hemoglobin increased by at least 0.8 g / L and non-responders if this increase did not occur. Result. 25 patients were reponders, the ROC curves analysis showed the Ret-He with the largest AUC of 0.862 similar to the AUC of 0.833 that showed the IST, but the first is more sensitive (72% CI 95%: 51-88% vs 52% 95% CI 31-72%) and similar specificity (94.7% CI 95%: 74-100% vs 100% 95% CI 82-100%). Ferritin AUC was 0.772 and finally the IRF AUC was 0.7. The Ret-He, to a cutoff of 29.5 pg was the best combination of sensitivity and specificity (72 and 94.7 respectively), and the sensitivity of the combination Ret-He/IST rose to 80% specificity 94.7%. Conclusions. According to these results it could consider to Ret-He and the Ret-He/IST combination of clinical utility for the identification of the iron deficit in patients in chronic haemodialysis. Antecedentes. La deficiencia de hierro es la principal causa de falla en la respuesta a la eritropoyetina (EPO) en pacientes en hemodiálisis. Existen diversas pruebas de laboratorio para detectar dicha deficiencia, la Ferritina y el índice de saturación de Transferrina (IST) son las de uso más común pero sus limitaciones en esta población de pacientes hacen necesaria la búsqueda de otros parámetros para mejorar la identificación del estado ferropénico. Objetivo. Evaluar la capacidad de la Hemoglobina Reticulocitaria Equivalente (Ret-He) de predecir deficiencia de hierro, teniendo como estándar de referencia al aumento de hemoglobina (Hb) en respuesta al aporte de hierro. Materiales y Métodos: 44 pacientes en hemodiálisis crónica y dosis fija de EPO recibieron 400 mg de hierro intravenoso. Se midieron Hb, Ret-He, Fracción de Reticulocitos Inmaduros (IRF), IST y Ferritina previa a la administración de hierro. Luego de 20 a 30 días de finalizada la carga los pacientes se clasificaron en respondedores si la Hb aumentaba en por lo menos 0,8 g/L y no respondedores si este incremento no ocurría. Resultados: 25 pacientes fueron respondedores; el análisis por curvas COR mostró al Ret-He con la mayor ABC de 0,862 similar a la ABC de 0,833 que mostró el IST, pero el primero con mayor sensibilidad (72% IC95%: 51-88% vs 52% IC95%: 31-72%) y especificidades similares (94.7% IC95%: 74-100% vs 100% IC95%: 82-100%). El ABC de Ferritina fue 0,772 y por último el ABC de IRF 0,7. El Ret-He, para un punto de corte de 29,5 pg mostró la mejor combinación de sensibilidad y especificidad (72 y 94,7 respectivamente), y la sensibilidad de la combinación Ret-He/IST se elevó a 80% con especificidad de 94,7%. Conclusiones. De acuerdo a estos resultados podría considerarse al Ret-He y la combinación Ret-He/IST de utilidad clínica para la identificación del déficit de hierro en pacientes en hemodiálisis crónica. Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2011-07-03 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/21535 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 68 No. 2 (2011); 51-55 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 68 Núm. 2 (2011); 51-55 Revista da Faculdade de Ciências Médicas de Córdoba; v. 68 n. 2 (2011); 51-55 1853-0605 0014-6722 10.31053/1853.0605.v68.n2 spa https://revistas.unc.edu.ar/index.php/med/article/view/21535/21261 Derechos de autor 2018 Universidad Nacional de Córdoba |