ASSOCIATION OF RETICULOCYTE HEMOGLOBIN EQUIVALENT AND FUNCTIONAL IRON DEFICIENCY ON REGULAR HEMODIALYSIS CHRONIC KIDNEY DISEASE PATIENTS

TESIS

Abstract

By : Dr.Sang Bagus Ketut Dwiadnyana

Email : dwea.79@gmail.com

Faculties : Fakultas Kedokteran

Department : PS. ILMU PENYAKIT DALAM

ASSOCIATION OF RETICULOCYTE HEMOGLOBIN EQUIVALENT AND FUNCTIONAL IRON DEFICIENCY ON REGULAR HEMODIALYSIS CHRONIC KIDNEY DISEASE PATIENTS Anemic has become one of the several complications that occured in chronic kidney disease (CKD) patients. Mortality, length of stay, decreasing of cardiac function and poor on quality of life will be increased in anemic condition. Multifactor has proposed to be etiology of anemic in CKD patient and iron deficiency became ones of them. Two type well known of iron deficiency in CKD were absolute iron deficiency and functional iron deficiency. Feritin serum has many disadvantages to determining iron status in inflammation condition. Ret-He is blood analyze technique to measuring incorporated iron in reticulocyte haemoglobin which is providing early and update iron status without inflammation process leverages. Cross sectional analytic was conducted to this observational study. Association between Ret-He and functional iron deficiency was analyzed using simple log regression study. Consecutive random sampling technique was used to obtaining sample in haemodialysis unit at Sanglah Hospital Bali. Transferin saturation < 20% and SF ? 200 ng/ml were used to identified functional iron deficiency. This study enrolled 71 patients consist of 56,3% males and 43,7% females. Median data of SI, SF, ST and Ret-He were revealed consecutively 57,00 (13,00 166,00) g/dL; 629,00 (62,80 6684,00) ng/ml; 31,57 (9,90 97,07) % and 30,60 (20,40 42,70) pg. Significant association was found between Ret-He and functional iron deficiency in regular haemodialysis CKD patients (OR = 0,78; p < 0,015) and increasing 1 unit of Ret-He will reducing risk of functional iron deficiency 0,78 times as the conclusion. Reticulocyte hemoglobin equivalent could be used to predict the presence of functional iron deficiency states.

Keyword : Functional iron deficiency, CKD, Ret-He

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