evaluation of predicting the value of the reticulocyte hemoglobin equivalent for iron deficiency in chronic kidney disease patients

Background: iron management is essential for anemia treatment in chronic kidney disease. the reticulocyte hemoglobin equivalent (ret-he) is a reticulocyte parameter that reflects hemoglobin synthesis of newly formed erythrocytes in the bone marrow in real-time. objectives: this study aims to evaluate the role of reticulocyte hemoglobin equivalent (ret-he) in predicting iron deficiency in chronic kidney disease (ckd) patients. methods: following a descriptive cross-sectional observational design, this study was conducted on 131 adult patients with ckd stages 3 - 5. laboratory indices, including complete blood count, some biochemical indices, iron status, and reticulocyte indices (including ret-he), were measured. iron deficiency (id) was defined as tsat < 20%, where serum ferritin level > 100 ng/ml was defined as functional id, while serum ferritin level <100 ng/ml was defined as absolute id. results: nearly 42% of patients had id. the mean concentration of ret-he in ckd patients with id was significantly lower than that of patients without id (p < 0.001). based on the receiver operating characteristic (roc) curve model, ret-he had a good predictive value for id in ckd patients (auc = 0.762; p < 0.001; cut-off value: 28.15 g/l, the sensitivity of 45.5%, and the specificity of 100%). serum iron, ret-he, serum albumin, and mean corpuscular volume (mcv) were independent risk factors to predict id in ckd patients. conclusions: this study demonstrated that ret-he is an appropriate index to predict id in ckd patients.