The validity of reticulocyte hemoglobin content and percentage of hypochromic red blood cells for screening iron-deficiency anemia among patients with end-stage renal disease: a retrospective analysis

BACKGROUND: Early detection of iron-deficiency anemia (IDA) can enhance the efficiency and effectiveness of clinical treatment and quality of life for end-stage renal disease (ESRD) patients. This study aimed to evaluate the validity of CHr and %Hypo in screening IDA among ESRD patients and compare their performance with screening IDA among non-ESRD patients. METHOD: A retrospective analysis of 312 participants was conducted at Cho Ray Hospital, Vietnam, including healthy control participants and ESRD patients. Receiver operator characteristics curves and the area under the curve (AUC) of models were used to evaluate the performance of CHr, %Hypo. Optimal cut-off values were determined using Youden’s index. RESULTS: Detecting IDA in ESRD patients is more complicated, as the screening performance of CHr and %Hypo in predicting IDA among ESRD patients were lower than non ESRD group, but still reasonable with AUC = 0.748 (95% CI: 0.656–0.840, power = 0.997) and 0.740 (95% CI: 0.647–0.833, power = 0.996), respectively. Cut-off values of CHr < 31.5 pg and %Hypo> 10.0 pg are recommended to obtain optimal screening ability for Vietnamese ESRD patients. CONCLUSION: CHr and %Hypo appears to be useful tools for screening IDA among both non ESRD and ESRD patients. The low cost and accessible of the two markers encourage their utility as effective screening tools in clinical practice.