Analytical and biological variation in measures of anemia and iron status in patients treated with maintenance hemodialysis

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
David B Van WyckResmi Gupta

Abstract

To make informed decisions in dosing erythropoiesis-stimulating agents and intravenous iron therapy, clinicians must determine whether differences between current and previous test results for anemia and iron status markers reflect expected variation, a significant change, or an actual trend. Prospective observational cohort study. 30 patients undergoing thrice-weekly in-center hemodialysis. Within-patient biological variations in hemoglobin (Hb) level, hematocrit (Hct), reticulocyte Hb content, transferrin saturation (TSAT), and ferritin level were determined over 12 consecutive treatment days. We separately measured same-sample analytical variation and within-patient biological variation (coefficient of variation), then calculated the number of sampling days needed to determine the true or homeostatic value for each analyte with 95% probability. We also evaluated whether results differed among the first, second, and third dialysis days of the week. Biological variation differed by analyte. Hb level (4.0%), Hct (4.0%), and reticulocyte Hb content (4.8%) showed much lower variation than TSAT (38.2%) or ferritin level (15.1%). Analytical variation ranged from 2.0%-6.9% for all analytes. We found that one sample day would be suff...Continue Reading

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Citations

Aug 21, 2015·Critical Reviews in Clinical Laboratory Sciences·Natasha M Archer, Carlo Brugnara
Jul 2, 2014·Seminars in Dialysis·Anatole Besarab, Lynda Szczech
Feb 14, 2015·Clinics in Laboratory Medicine·George S Cembrowski, Gwen Clarke
Mar 23, 2017·Hemodialysis International·Adam E Gaweda
Sep 23, 2014·American Journal of Clinical Pathology·Ellinor I B PeerschkePeter Maslak
Feb 19, 2020·Clinical Chemistry and Laboratory Medicine : CCLM·Chenbin LiWenbin Zhou
Apr 19, 2018·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Wesley Hayes
May 11, 2018·International Journal of Chronic Diseases·Axel DignassJürgen Stein
Jul 17, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Angelo KaraboyasBruce M Robinson
Feb 27, 2013·Journal of Diabetes Science and Technology·Kaila A Topping, George S Cembrowski
Jun 20, 2020·Clinica Chimica Acta; International Journal of Clinical Chemistry·Joanna JungSridevi Devaraj

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