Correlation Between Reticulocyte Hemoglobin Equivalent and Serum Markers of Iron Status of End Stage Renal Disease Patients on Hemodialysis in Kenyatta National Hospital

Abstract

Background: Anemia is an almost universal complication of end stage renal disease (ESRD). Iron deficiency contributes significantly towards anemia in ESRD, having a local prevalence of 35%. Iron status is traditionally assessed by ferritin and transferrin saturation (TSAT). Studies show biological, analytical and intra-patient variability in these tests. Reticulocyte hemoglobin equivalent (Ret He), a new parameter in the complete blood count (CBC), measures hemoglobin content in reticulocytes and can be used to determine iron status in ESRD. Its measurement is cheap, fast and convenient, making its use ideal in our local setting. There is no local data to provide guidelines for its use in Kenya. Objective: This study aims to investigate the correlation between Ret He and serum markers of iron status of ESRD patients on hemodialysis (HD) in Kenyatta National Hospital (KNH). Methodology: This study is a cross-sectional descriptive study. Using consecutive sampling, ninety ESRD patients undergoing HD in KNH were recruited. Blood was collected for measuring CBC, Ret He, iron, ferritin and TSAT. Patient interviews and files were utilized to obtain relevant demographic and medical information. Data analysis: Data analysis was carried out using the Statistical Package for Social Sciences. The data summary was also, reported as histograms, frequency tables, line graphs, bar graphs, pie charts, and written reports. Significance of the study: The expected outcome is a correlation between Ret He and serum markers of iron status that can inform the use of Ret He as an alternative test for iron status assessment, thus improving anemia treatment, of ESRD patients undergoing HD.