UNIVERSITAS AIRLANGGA



Detail Article

Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 21 / No. 1 / Published : 2014-01

Order : 8, and page :32 - 39

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Original Article :

Reticulocyte hemoglobin level of absolute iron deficiency anemia and nonabsolute iron deficiency anemia in end state renal disease undergoing maintenance hemodialysis

Author :

  1. Amelia Rachmiwatie*1
  2. Noormartany*2
  3. Rubin Surachno Gondodiputro*3
  4. Delita Prihatni*4
  1. Departemen Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung
  2. Departemen Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung
  3. Departemen Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung
  4. Departemen Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung

Abstract :

Absolute Iron Deficiency Anemia (IDA) is one of the complications in the End State Renal Disease (ESRD) patients undergoing maintenance hemodalysis, with an incidence of 76.4%. If this condition is not properly addressed, it can lead to impaired cardiac function and increased mortality. The incidence of this case is between 30−45%. The determination of the iron status in ESRD patients wqs set by the Perhimpunan Nefrologi Indonesia 2011 using serum ferritin and transferrin saturation, but they do not provide a meaningful change in the value of the initial state of the iron deficiency. This condition should be examined with other parameters combination as well as those influenced by diurnal variation and infection-inflammation condition. Reticulocyte hemoglobin (Ret-He) parameter can be used as a marker of bone marrow iron availability because these reticulocytes are young erythrocytes released from the bone marrow into the circulation. These conditions were circulated only within a short time about 1-2 days before becoming mature erythrocytes. The aim of this study was to determine the Ret-He level diferentiation between absolute IDA and non absolute IDA states in ESRD patients whom underwent maintenance hemodialysis. This research was conducted in the Laboratory of Clinical Pathology-RSHS-Bandung from September 2012 to June 2013. The study design was cross-sectional. All subjects were ESRD patients undergoing hemodialysis maintenance for at least three (3) months and consisted of absolute IDA and non-absolute IDA based on the results of the ferritin and transferrin saturation calculations according to the criteria of Pernefri 2011 Reticulocyte hemoglobin levels were checked using a fluorescence flowcitometry principle in the automated hematology analyzer. In this study it was found that the Ret-He mean in the absolute IDA was 26.1 pg/cell and 35.9 pg/cell in non absolute IDA. Statistical analysis was performed using Independent T-test. A total of 61 undergoing maintenance hemodialysis subjects participating in this study comprised patients with absolute IDA and non-absolute IDA who met the inclusion and exclusion criteria. It can be concluded that the Ret-He level in statistical analysis showed absolute IDA which was meaningful lower than nonabsolute IDA in ESRD patients undergoing maintenance hemodialysis (p<0.001).   Anemia Defisiensi Besi (ADB) absolut merupakan komplikasi Gagal Ginjal Terminal (GGT) dengan Hemodialisis (HD) yang rutin dan dapat mengakibatkan gangguan sistem kardiovaskular serta meningkatkan kematian. Penentuan anemia di pasien GGT berdasarkan Perhimpunan Nefrologi Indonesia (Pernefri) 2011 menggunakan tolok ukur feritin dan saturasi transferin, tetapi keduanya kurang peka, sebab harus diperiksa bersamaan serta dipengaruhi ragaman diurnal dan infeksi-inflamasi. Tolok ukur Hemoglobin Retikulosist (Ret-He) dapat digunakan sebagai petanda ketersediaan zat besi sumsum tulang terkini, karena retikulosit merupakan eritrosit muda yang dilepaskan dari sumsum tulang ke edaran darah dan beredar singkat antara 1−2 hari. Tujuan penelitian ini untuk mengetahui perbedaan Ret-He di ADB absolut dan yang nonADB absolut di pasien GGT terkait HD rutin. Penelitian ini dilakukan di laboratorium Patologi Klinik-RSHS Bandung sejak September 2012−Juni 2013. Rancangan penelitian adalah potong silang. Subjek penelitian adalah pasien GGT hemodialisis rutin, terdiri dari mereka yang ADB absolut dan bukan berdasarkan hasil feritin dan saturasi transferin. Pemeriksaan Ret-He menggunakan asas fluorescence flowcitometry. Sebanyak 61 subjek yang disertakan dalam penelitian ini terdiri dari kelompok ADB absolut dan yang nonADB absolut adalah mereka yang memenuhi patokan kesertaan dan yang tidak. Rerata Ret-He ADB absolut adalah 26,1 pg/sel dan yang nonADB absolut adalah 35,9 pg/sel. Analisis statistik menggunakan Independent T-test. Kadar Ret-He ADB absolut lebih rendah secara bermakna dibandingkan dengan yang nonADB absolut pasien GGT yang menjalani HD rutin (p<0,001).

Keyword :

Absolute iron deficiency anemia, end state renal disease, maintenance hemodialysis, nonabsolute iron deficiency anemia, Ret-He level,


References :

Skorecki K, Bargman J,(2010) Chronic Kidney Disease. Dalam: Jameson J, Loscalzo J, editor. Harrison’s Nephrology and Acid Base Disorders Hal : 113-36 : McGraw Hill

Spinowitz B, Kausz A, Baptista J, Noble S, Sotinanthan R, Bernardo M,(2008) Ferumoxytol for Treating Iron Deficiency Anemia in Chronic Kidney Disease Vol 19 No.8 Hal 1599-605 : J Am Soc Nephrol





Archive Article

Cover Media Content

Volume : 21 / No. : 1 / Pub. : 2014-01
  1. The Level Of Interleukin-6 Plasma In Diabetes Mellitus Patients With And Without Diabetic Retinopathy
  2. Correlation Plasma Fibrinogen With Intima-media Thickness Of Carotid Artery In Diabetes Mellitus
  3. Matrix Metalloproteinase-2 In Breast Cancer Metastastis
  4. Potassium In Multidrug Resistance Tuberculosis With Kanamycin
  5. Safe Blood And Voluntary Non-remunerated Blood Donors
  6. Mean Platelet Volume In Diabetes Mellitus
  7. Ratio Of Urinary Uric Acid Levels And Serum Uric Acid In Type 2 Diabetes Mellitus
  8. Reticulocyte Hemoglobin Level Of Absolute Iron Deficiency Anemia And Nonabsolute Iron Deficiency Anemia In End State Renal Disease Undergoing Maintenance Hemodialysis
  9. Immature Platelet Fraction In Dengue Fever And Dengue Hemorrhagic Fever
  10. Cryptococcal Antigen Of Acquired Immune Deficiency Syndrome With Lateral Flow Assay And Cryptococcus Antigen Latex Agglutination System
  11. T-cd4+ And Lipid Profile In Hiv)
  12. Liver Function Parameters Based On Degree Of Liver Fibrosis In Chronic Liver Disease
  13. Brain Derived Neurotrophic Factor (bdnf) As A Prognostic Factor In Severe Head Injury
  14. Hpv Genotype And Hpv Infection Pattern Related To The Histopathological Type Of Cervical Cancer)
  15. Glut 4 In Adipose Tissue
  16. The Diagnostic Value Of Anti Dengue Iga And Anti Dengue Igm/igg In Dengue Virus Infection)
  17. Vitamin D Deficiency And Diseases
  18. Lineage Switch From Acute Lymphoblastic Leukemia To Acute Myelomonocytic Leukemia At A 26 Years Old Woman
  19. The Role For Clinical Pathologist In Hospital Accreditation

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