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. 2025 Jan 1;19(1):50-59.
doi: 10.18502/ijhoscr.v19i1.17824.

The Correlation between Reticulocyte Hemoglobin Equivalent (RET-He), Iron Status, and Erythrocyte Indices in Chronic Kidney Disease Patients at Prof. Dr. R.D. Kandou Manado Hospital

Hessyani Patrisia Theodora Raranta  1 , Purwanto Adipireno  2 , Indranila Kustarini Samsuria  2
Affiliations

The Correlation between Reticulocyte Hemoglobin Equivalent (RET-He), Iron Status, and Erythrocyte Indices in Chronic Kidney Disease Patients at Prof. Dr. R.D. Kandou Manado Hospital

Hessyani Patrisia Theodora Raranta et al. Int J Hematol Oncol Stem Cell Res. .

Abstract

Background: Chronic Kidney Disease (CKD) is a public health concern with anemia being a major complication. RET-He is a cost-effective parameter to assess iron status in CKD, but further research is necessary to assess its correlation with existing parameters. This study attempted to investigate the correlation between RET-He, iron status, and erythrocyte indices among CKD patients. Materials and Methods: A cross-sectional study involving 110 CKD patients who underwent routine hematology and iron profile tests (serum iron/SI, total iron binding capacity/TIBC, transferrin saturation/TSAT, and ferritin). RET-He was then measured using a Sysmex XN-1000 hematology analyzer. Statistical tests were used to define the correlation between RET-He), iron status, and erythrocyte indices. Results: There was a significant positive correlation between RET-He and SI (r = 0.349; p = 0.000), TSAT (r = 0.393; p = 0.000), and ferritin (r = 0.279; p = 0.003). Among CKD patients with excess iron levels, there was a moderate correlation between RET-He and TSAT (r = 0.404; p = 0.000). Conclusion: The study found a significant correlation between RET-He levels and iron status markers in CKD patients. RET-He is recommended as an additional parameter to assess iron status and as an additional method to estimate TSAT and ferritin levels, especially in settings where chemistry analyzers are unavailable. Further research is required to establish RET-He cut-off values for identifying excessive iron levels in CKD patients.

Keywords: Erythrocyte indices, CKD; Iron status; Reticulocyte hemoglobin equivalent.

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Figures

Figure 1
Figure 1
Pearson’s correlation scatterplots between Ret-He, Hb, Hct, and RBC
Figure 2
Figure 2
Spearman’s ρ correlation scatterplots between RET-He, SI, TIBC, TSAT, and Ferritin
See this image and copyright information in PMC

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