Percentage of hypochromic red blood cells as predictor of erythropoietic and iron response after i.v. iron supplementation in maintenance haemodialysis patients

Braun, J.; Lindner, Karolina; Schreiber, Martin J.; Heidler, R; Hörl, Walter H.

doi:10.1093/ndt/12.6.1173

Cited by 55 publications

(27 citation statements)

References 5 publications

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“…The value for % Hypo increases in iron deficiency, our mean normal value being 1.0%, and values greater than 4.8% represent true iron deficiency. This correlates with other published data which suggested true iron deficiency to be defined as a % Hypo of >10% and a cut-off for functional iron deficiency of 5% [11]. The primary purpose of this study was to determine whether the new parameters on the XE-2100 correlated with CHr and % Hypo in detecting potential functional iron deficiency in chronic renal failure.…”

Section: Discussionsupporting

confidence: 81%

“…It was also recognised that there can be a normal value for % Hypo in association with low serum ferritin levels (i.e. absolute iron deficiency) [11]. In these patients it can be assumed that iron supply to the marrow is being maintained at a rate sufficient to allow normal haemoglobinization of red cells even though total body iron stores are depleted.…”

Section: Discussionmentioning

confidence: 99%

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New Red Cell Parameters on the Sysmex XE-2100<sup>TM</sup> as Potential Markers of Functional Iron Deficiency

Briggs¹,

Rogers²,

Thompson³

et al. 2001

Transfus Med Hemother

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Background:The ideal approach to monitor the haematological response of patients with anaemia associated with chronic renal failure during erythropoietin therapy is controversial. The reticulocyte haemoglobin content (CHr) and percentage hypochromic red cells (% Hypo) may be used as sensitive and specific indicators of functional iron deficiency in clinical situations with otherwise normal red cell indices. In the reticulocyte channel of a new blood cell counter using fluorescence flow cytometry, the Sysmex XE-2100, two novel parameters are determined (RBC-Y and RET-Y) by measuring the mean value of the forward scatter histograms of red cells and reticulocytes. These values seem to equate with red cell/reticulocyte haemoglobin content. Material and Methods:40 normal healthy males, 70 patients with iron deficiency (selected by indices), 90 patients with chronic renal failure before the start of dialysis or receiving continuous ambulatory peritoneal dialysis and 115 patients on long-term haemodialysis were studied on two different blood cell counters. A soluble transferrin receptor assay and measurements of ferritin were used to assess iron status. Results:A normal and iron-deficient range for RBC-Y and RET-Y has been defined and compared to the values for CHr and % Hypo. Excellent correlation between CHr and RET-Y (r = 0.94) is obtained in all groups and reasonable correlation with % Hypo and RBC-Y (r = 0.84). The soluble transferrin receptor had similar correlation with RET-Y and RBC-Y (r = 0.68) and % Hypo (r = 0.66) but less good with CHr (r = 0.55). Ferritin was an unreliable indicator of functional iron deficiency. ConclusionsThe two new parameters on the XE-2100 seem to indicate functional iron deficiency, correlate with soluble transferrin receptor levels and are acceptable alternatives to CHr and % Hypo on a routine haematology analyser.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

New Red Cell Parameters on the Sysmex XE-2100<sup>TM</sup> as Potential Markers of Functional Iron Deficiency

Briggs¹,

Rogers²,

Thompson³

et al. 2001

Transfus Med Hemother

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“…36 However, there are other studies which suggested lower threshold values for Hypo. 32,[37][38][39][40] Both these tests are not widely available in India.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of iron status in patients with end stage renal disease

et al. 2017

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Background: Anaemia is almost universal in haemodialysis patients. Here, we evaluated the utility and clinical implications of the commonly employed tests in assessing iron status in haemodialysis patients.Methods: In this prospective observational study, we enrolled 100 prevalent haemodialysis patients, and measured transferrin saturation (TSAT) and serum ferritin at enrolment. Patients were categorized to have normal, deficient, overload, or indeterminate status of iron based on KDOQI guidelines. To study anaemia trend, haemoglobin (Hb) level at time of enrolment, as well as levels 3-months before and 3-months after enrolment, were collected. Patient survival outcomes were also obtained till October 2016.Results: Using serum ferritin and TSAT, iron status was determinable in 48% of the patients ie 20%-normal iron status, 25% - iron deficiency, 3% - iron overload. Fifty-two percent of the patients’ iron status was indeterminate by current parameters. In spite of being on standard-of-care treatment in our centre, we observed that mean-Hb level of patients in the indeterminate group showed insignificant increases compared to normal- and deficient-groups. Mean delta-Hb levels over 6-months were 0.80±1.54 g/dl in the indeterminate group, compared to 1.87±1.95 g/dl in the deficient group (P=0.03). In our cohort, 57% had died and 5 lost follow-ups during the study (P=0.30 between groups).Conclusions: Serum ferritin and TSAT accurately categorized the iron status of 48% haemodialysis patients in our study. Divergent serum ferritin and TSAT values, or an iron indeterminate state was prevalent in 52% of our urban dialysis cohort. The indeterminate group had inferior increases in Hb over time with current treatment, showing clinical relevance of this finding. Our data suggests the need for more sensitive indices to accurately assess iron status, and improve anaemia management.

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“…Since acceptable to increased serum ferritin levels may occur in anemic patients (functional sideropenia), the fraction of hypochromic red blood cells has been proposed as an indicator for assessing iron status [20]. An effective iron replacement regimen may additionally mean that lower erythropoietin doses are required to obtain target hemoglobin levels [21]. …”

Section: When and How Should Anemia Be Treated?mentioning

confidence: 99%

Erythropoietin in Radiation Oncology – A Review

Henke¹,

Guttenberger²

2000

Oncology

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The therapeutic potential of erythropoietin gains increasing attention among radiation oncologists because the prognosis is better for patients with high blood hemoglobin levels following radiotherapy. However, there is still a debate on how hemoglobin affects radiotherapy. Further, the means to manipulate the hemoglobin level, their indication and administration need to be clarified. Available experimental and clinical data on hypoxia, anemia and on their treatment with erythropoietin have been extensively discussed at an international conference in Freiburg, Germany, in June 1999. This report gives a summary reviewing the topic.

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Percentage of hypochromic red blood cells as predictor of erythropoietic and iron response after i.v. iron supplementation in maintenance haemodialysis patients

Cited by 55 publications

References 5 publications

New Red Cell Parameters on the Sysmex XE-2100<sup>TM</sup> as Potential Markers of Functional Iron Deficiency

New Red Cell Parameters on the Sysmex XE-2100<sup>TM</sup> as Potential Markers of Functional Iron Deficiency

Evaluation of iron status in patients with end stage renal disease

Erythropoietin in Radiation Oncology – A Review

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