Reticulocyte parameters for monitoring anemia in patients with chronic kidney disease on peritoneal dialysis

Detalhes bibliográficos
Autor(a) principal: Merlin,Júlio C.
Data de Publicação: 2021
Outros Autores: Amaral,Andrea N. M., Claro,Ligia, Moraes,Thyago P., Erthal,Cyntia L., Pecoits Filho,Roberto
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Jornal Brasileiro de Patologia e Medicina Laboratorial (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-24442021000100419
Resumo: ABSTRACT Introduction: Anemia is a complication with impact on morbidity and mortality in chronic kidney disease (CKD) patients. Current markers for the diagnosis and monitoring of anemia in CKD are limited by the interrelation between erythropoiesis, iron stores, inflammation, and the resistance to treatment with erythropoiesis stimulant agents (ESA). Objective: The aim of this study was to analyze the role of immature reticulocyte fraction (IRF) and hemoglobin concentration in reticulocytes (RET-He) by the hematology analyser Sysmex XN-5000 in the monitoring of CKD anemia in peritoneal dialysis patients. Methods: This was a prospective, observational multicenter study which compared IRF and RET-He with parameters recommended by the guidelines. Inflammatory biomarkers were analyzed by the Luminex® Multiplexing Instruments system. Thirty-five patients (59 ± 13 years old; 51% men) were included in the analysis. Results: Hemoglobin was 12.2 ± 2 g/dl; 87% had resistance to ESA. Patients with erythropoietin resistance index (ERI) in the upper quartile presented a significantly higher of IRF and a lower percentage of iron deficiency (12%) compared to ferritin (82%) and transferrin saturation index (STI) (51%). Interleukin-6 (IL-6) levels correlated with the percentage of medium fluorescence reticulocyte (MFR) (r = 0.45, p < 0.03). Hemoglobin values after 60 and 180 days were consistently higher in the group of patients with a IRF% lower than 10.5. Conclusion: IRF and RET-He may add value in the iron deficiency investigation, as well as in the identification of patients with ERI. Due to the restricted number of patients analyzed in this study, future studies should be encouraged in larger populations and with prospective follow-up, to validate our findings.
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spelling Reticulocyte parameters for monitoring anemia in patients with chronic kidney disease on peritoneal dialysisanemiareticulocytesperitoneal dialysiskidney failure chronicABSTRACT Introduction: Anemia is a complication with impact on morbidity and mortality in chronic kidney disease (CKD) patients. Current markers for the diagnosis and monitoring of anemia in CKD are limited by the interrelation between erythropoiesis, iron stores, inflammation, and the resistance to treatment with erythropoiesis stimulant agents (ESA). Objective: The aim of this study was to analyze the role of immature reticulocyte fraction (IRF) and hemoglobin concentration in reticulocytes (RET-He) by the hematology analyser Sysmex XN-5000 in the monitoring of CKD anemia in peritoneal dialysis patients. Methods: This was a prospective, observational multicenter study which compared IRF and RET-He with parameters recommended by the guidelines. Inflammatory biomarkers were analyzed by the Luminex® Multiplexing Instruments system. Thirty-five patients (59 ± 13 years old; 51% men) were included in the analysis. Results: Hemoglobin was 12.2 ± 2 g/dl; 87% had resistance to ESA. Patients with erythropoietin resistance index (ERI) in the upper quartile presented a significantly higher of IRF and a lower percentage of iron deficiency (12%) compared to ferritin (82%) and transferrin saturation index (STI) (51%). Interleukin-6 (IL-6) levels correlated with the percentage of medium fluorescence reticulocyte (MFR) (r = 0.45, p < 0.03). Hemoglobin values after 60 and 180 days were consistently higher in the group of patients with a IRF% lower than 10.5. Conclusion: IRF and RET-He may add value in the iron deficiency investigation, as well as in the identification of patients with ERI. Due to the restricted number of patients analyzed in this study, future studies should be encouraged in larger populations and with prospective follow-up, to validate our findings.Sociedade Brasileira de Patologia Clínica2021-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1676-24442021000100419Jornal Brasileiro de Patologia e Medicina Laboratorial v.57 2021reponame:Jornal Brasileiro de Patologia e Medicina Laboratorial (Online)instname:Sociedade Brasileira de Patologia (SBP)instacron:SBP10.5935/1676-2444.20210038info:eu-repo/semantics/openAccessMerlin,Júlio C.Amaral,Andrea N. M.Claro,LigiaMoraes,Thyago P.Erthal,Cyntia L.Pecoits Filho,Robertoeng2021-11-25T00:00:00Zoai:scielo:S1676-24442021000100419Revistahttp://www.scielo.br/jbpmlhttps://old.scielo.br/oai/scielo-oai.php||jbpml@sbpc.org.br1678-47741676-2444opendoar:2021-11-25T00:00Jornal Brasileiro de Patologia e Medicina Laboratorial (Online) - Sociedade Brasileira de Patologia (SBP)false
dc.title.none.fl_str_mv Reticulocyte parameters for monitoring anemia in patients with chronic kidney disease on peritoneal dialysis
title Reticulocyte parameters for monitoring anemia in patients with chronic kidney disease on peritoneal dialysis
spellingShingle Reticulocyte parameters for monitoring anemia in patients with chronic kidney disease on peritoneal dialysis
Merlin,Júlio C.
anemia
reticulocytes
peritoneal dialysis
kidney failure chronic
title_short Reticulocyte parameters for monitoring anemia in patients with chronic kidney disease on peritoneal dialysis
title_full Reticulocyte parameters for monitoring anemia in patients with chronic kidney disease on peritoneal dialysis
title_fullStr Reticulocyte parameters for monitoring anemia in patients with chronic kidney disease on peritoneal dialysis
title_full_unstemmed Reticulocyte parameters for monitoring anemia in patients with chronic kidney disease on peritoneal dialysis
title_sort Reticulocyte parameters for monitoring anemia in patients with chronic kidney disease on peritoneal dialysis
author Merlin,Júlio C.
author_facet Merlin,Júlio C.
Amaral,Andrea N. M.
Claro,Ligia
Moraes,Thyago P.
Erthal,Cyntia L.
Pecoits Filho,Roberto
author_role author
author2 Amaral,Andrea N. M.
Claro,Ligia
Moraes,Thyago P.
Erthal,Cyntia L.
Pecoits Filho,Roberto
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Merlin,Júlio C.
Amaral,Andrea N. M.
Claro,Ligia
Moraes,Thyago P.
Erthal,Cyntia L.
Pecoits Filho,Roberto
dc.subject.por.fl_str_mv anemia
reticulocytes
peritoneal dialysis
kidney failure chronic
topic anemia
reticulocytes
peritoneal dialysis
kidney failure chronic
description ABSTRACT Introduction: Anemia is a complication with impact on morbidity and mortality in chronic kidney disease (CKD) patients. Current markers for the diagnosis and monitoring of anemia in CKD are limited by the interrelation between erythropoiesis, iron stores, inflammation, and the resistance to treatment with erythropoiesis stimulant agents (ESA). Objective: The aim of this study was to analyze the role of immature reticulocyte fraction (IRF) and hemoglobin concentration in reticulocytes (RET-He) by the hematology analyser Sysmex XN-5000 in the monitoring of CKD anemia in peritoneal dialysis patients. Methods: This was a prospective, observational multicenter study which compared IRF and RET-He with parameters recommended by the guidelines. Inflammatory biomarkers were analyzed by the Luminex® Multiplexing Instruments system. Thirty-five patients (59 ± 13 years old; 51% men) were included in the analysis. Results: Hemoglobin was 12.2 ± 2 g/dl; 87% had resistance to ESA. Patients with erythropoietin resistance index (ERI) in the upper quartile presented a significantly higher of IRF and a lower percentage of iron deficiency (12%) compared to ferritin (82%) and transferrin saturation index (STI) (51%). Interleukin-6 (IL-6) levels correlated with the percentage of medium fluorescence reticulocyte (MFR) (r = 0.45, p < 0.03). Hemoglobin values after 60 and 180 days were consistently higher in the group of patients with a IRF% lower than 10.5. Conclusion: IRF and RET-He may add value in the iron deficiency investigation, as well as in the identification of patients with ERI. Due to the restricted number of patients analyzed in this study, future studies should be encouraged in larger populations and with prospective follow-up, to validate our findings.
publishDate 2021
dc.date.none.fl_str_mv 2021-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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Sociedade Brasileira de Patologia Clínica
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Sociedade Brasileira de Patologia Clínica
dc.source.none.fl_str_mv Jornal Brasileiro de Patologia e Medicina Laboratorial v.57 2021
reponame:Jornal Brasileiro de Patologia e Medicina Laboratorial (Online)
instname:Sociedade Brasileira de Patologia (SBP)
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reponame_str Jornal Brasileiro de Patologia e Medicina Laboratorial (Online)
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