الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
Adequate and available iron stores are essential to the efficient
management of anemia in patients with end-stage renal disease (ESRD)
on hemodialysis ( Schmidt et al., 2005).
The advent of human recombinant erythropoietin (rHuEPO)
revolutionized the management of renal anemia. A dose dependent rise in
hemoglobin levels can be anticipated with serially levels administered
rHuEPO as long as iron is available for use by the red blood cells
(Eschbach et al., 1989).
With iron deficiency, higher and higher rHuEPO dose will be
required to reach the target Hb and, ultimaltely The hematopoietic
response will be blunted (Macdougall et al., 1998).
Traditional measures of iron stores - transferrin saturation (TSA T)
level and serum ferritin have come under scrutiny because of their
inability to differentiate consistently between true (absolute) iron
deficiency and functional iron deficiency (i.e. the inability to mobilize
stored iron). Afunctional iron deficiency (suggested by low TSAT and
high ferritin level) occur when the release and utilization of iron stores in
the reticuloendothelial .system are blocked (Besarab et al., 1999) . ’
The propensity for serum ferritin and TSAT to act as positive and
negative acute - phase reactants respectively in response to inflammation
and other comorbidities common in ESRD confounds their interperetation
making the distinction between chronic inflammation and the presence of
stored iron (which may not be available to the erythron) difficuJt (Ali et
nl,1982).
Introtfuction
A promlsmg potential marker of iron stores is the reticulocyte
hemoglobin content (CHr) which is reduced in states of decreased iron
availability irrespective of the presence of stored iron. CRr correlates
well with the state of total body iron (Besarab et al., 2000).
Reticulocyte survive only approximately one day in the circulation
(Bhandari et al., 1997).
Therefore CHr provides ” snapshot” of the status of iron stores at
the level of erythrocyte on any given day (Fishbane et 01., 1997).