Hubungan Kadar Reticulocyte Hemoglobin(Ret-He) dengan Anemia Defisiensi Besi pada Anak Penderita Penyakit Ginjal Kronik di Rumah Sakit H. Adam Malik Medan

Abstract

Objectives: Iron deficiency anemia is a comorbidity that can increase the mortality of children with chronic kidney disease (CKD). Diagnosis of iron deficiency anemia in CKD is difficult because it requires a combination of parameters that are influenced by inflammation, making it impractical and expensive. The recommendation for a new parameter that is easier, cheaper, not influenced by inflammation and has good diagnostic value is reticulocyte hemoglobin (Ret-He). Reticulocyte hemoglobin is a measurement of the average hemoglobin contained in reticulocytes, which are immature red blood cells that have just been released from the bone marrow. Reticulocyte count itself is a good parameter for quantitative aspects of erythropoiesis, but reticulocyte hemoglobinization provides additional information about the quality of erythropoiesis that directly reflects hemoglobinization. Methods: This was an analytical observational study with a cross sectional design. The sample was patients aged < 18 years who had been diagnosed with iron deficiency anemia and chronic kidney disease at the polyclinic and inpatient Adam Malik Hospital, Medan between January and April 2024. The patient had blood drawn and then assessed at the clinical pathology laboratory. Data were analyzed using SPSS Ver. 26 with the chi square statistical test (95% CI and significance p<0.05). Results: This research was attended by 51 children, 24 children with Ret-He values ≤ 28,7 pg, there were 22 children (91.7%) who had iron deficiency anemia, while of the 27 children with Ret-He values > 28,7 pg, only 3 children (11.1%) had iron deficiency anemia. The results of the analysis using the chi square test showed p-value <0.001 and prevalence ratio 8.250. Conclusion: There is a significant relationship between the Ret-He value and iron deficiency anemia in children with CKD at Adam Malik Hospital Medan.