The use of the Ret-He measurement in renal patients.
Research type
Research Study
Full title
The utility of the measurement of the reticulocyte haemoglobin equivalent (Ret-He)in monitoring patients with chronic kidney disease being treated with erythropoiesis stimulating agents.
IRAS ID
144328
Contact name
Graham Ball
Contact email
Sponsor organisation
Lancashire Teaching Hospitals NHS Foundation Trust
Research summary
Patients with Chronic Kidney Disease (CKD) are frequently treated with erythropoietic stimulating agents (ESAs) to combat anaemia(low haemoglobin/ low red cells)a common complication of the disease. ESAs increase red cell production in the marrow but there needs also to be enough iron available to create healthy red cells. If availability cannot meet demand, functional iron deficiency (FID)develops, whereupon the red cells produced contain less haemoglobin and the patient is again at risk of anaemia.
Effective response to ESA therapy requires effective monitoring of iron availability but in FID, traditional biochemical markers may be misleading. Direct measurement of the reticulocyte haemoglobin content (CHr) may have an advantage over traditional biochemical markers when monitoring ESA therapy. Until recently, measurement has only been available on one analyser, the ADVIA 2120 (Bayer Diagnostics), but an alternative parameter, the reticulocyte haemoglobin equivalent (Ret-He)is available on the XE2100 (Sysmex, Japan) analyser at Royal Preston Hospital, though at present it is not reported, due to there being little local knowledge of it’s usefulness.
Further knowledge of the Ret-He parameter is required. This study will establish a local normal reference range and an iron-deficient reference range from anonymised surplus samples from the daily workload. The stability of the parameter will be determined using anonymised surplus samples. Finally, samples from patients attending the Renal Clinic for monitoring will be used to determine the diagnostic ability of the Ret-He parameter for iron deficiency by comparing values obtained to biochemical markers already in use. It is hoped that the study will show the usefulness of the parameter to renal clinicians and to the parameter being reported in the routine renal profile, ensuring that patients receive optimum treatment.It is also hoped that the study will provide a basis for further research as to whether the parameter could be routinely included in the reticulocyte report.REC name
East Midlands - Leicester Central Research Ethics Committee
REC reference
14/EM/0070
Date of REC Opinion
14 Feb 2014
REC opinion
Further Information Favourable Opinion