CORRELATION BETWEEN RETICULOCYTE HEMOGLOBIN EQUIVALENT AND IRON STATUS IN PEDIATRIC CHRONIC KIDNEY DISEASE

Abstract

Background: Anemia is a major complication of pediatric chronic kidney disease (CKD). Iron deficiency is one of the most common causes of anemia. Conventional markers of iron deficiency anemia, transferrin saturation (TSAT) and serum ferritin could be interfered with various factors. in CKD. Reticulocyte hemoglobin equivalent (Ret-He) is useful for assessing iron status among these patients. Methods: A descriptive cross-sectional study enrolling children with CKD stage 3 and above was conducted between April and November 2021. Demographic information was also collected. Correlation of Ret-He, anemia indices and markers of iron status were analyzed. Results: Among 50 participants, we found moderate positive correlations between Hb and Ret-He (r=0.518; p <0.001), Hct and Ret-He (r=0.403; p=0.004), and MCHC and Ret-He (r=0.667; p<0.001); a modest negative correlation between RDW and Ret-He (r=-0.616; p<0.001) and strong correlations between MCV and Ret-He (r=0.747; p<0.001) including MCH and Ret-He (r=0.865; p<0.001). No correlations between TSAT and Ret-He, serum ferritin and Ret-He, TSAT and Hb, or TSAT and Hct were observed. In addition, weak negative correlations between serum ferritin and Hb (r=-0.307; p=0.032) and between serum ferritin and Hct (r=-0.305; p=0.033) were detected. The median RetHe was 28.42 ± 3.37 pg. Twenty-seven participants (54%) met the criteria for iron deficiency anemia (cut-off value <29 pg) of which 2 (4%) had absolute iron deficiency and 9 (18%) had functional iron deficiency defined by conventional markers. Conclusion: Ret-He is a relevant marker of iron status among pediatric patients with CKD and correlates well with anemia indices which could help identify more patients with iron deficiency.