The relationship between reticulocyte hemoglobin content with C-reactive protein and conventional iron parameters in dialysis patients

Abstract

The relationship between reticulocyte hemoglobin content with C-reactive protein and conventional iron parameters in dialysis patients. Hackeng CM, Beerenhout CM, Hermans M, Van der Kuy PH, Van der Dussen H, Van Dieijen-Visser MP, Hamulyak K, Van der Sande FM, Leunissen KM, Kooman JP. Department of Clinical Chemistry, University Hospital Maastricht, The Netherlands. Adequate iron stores are a prerequisite for successful erythropoietin (EPO) therapy in hemodialysis (HD) patients. Nevertheless, iron status estimation in HD patients remains problematic, as most parameters are influenced by inflammation. The reticulocyte hemoglobin content (CHr) has recently been proposed as a useful tool in iron status assessment. However, the effect of inflammation on CHr remains unstudied. This study aimed to assess the relationship between CHr with other parameters of iron status as well as with C-reactive protein (CRP). This relationship was studied in all the patients (n=61) at our dialysis unit. CHr was significantly and positively related to transferrin saturation (TS) (rho=0.26; p or = 6 in 41% of patients and CHr < or = 29 pg in 13% of patients). This percentage was far lower in patients with CRP levels below the detection limit (2 mg/L) (26% and 0%, respectively). In conclusion, CHr is related to both TS and %Hypo, but not to serum ferritin, and is strongly influenced by the presence of inflammation (as determined by CRP). In patients with elevated CRP levels, it is very difficult to reach target iron status levels without exceeding the upper limits for serum ferriti