Diagnostic value of reticulocyte indices for the assessment of the iron status of cats with chronic kidney disease

J Vet Intern Med. 2022 Mar;36(2):619-628. doi: 10.1111/jvim.16367. Epub 2022 Jan 28.

Abstract

Background: Reticulocyte indices have been suggested as alternatives to transferrin saturation (TSAT) for iron status assessment in humans and dogs but they have not been evaluated thoroughly in cats.

Objectives: To assess the value of the reticulocyte indices for the diagnosis of iron deficiency in cats with chronic kidney disease (CKD) and chronic hematuria associated with subcutaneous ureteral bypasses (SUBs).

Animals: Sixty-four cats: 16 healthy, 14 CKD without SUB, and 34 CKD with SUB.

Methods: Prospective observational cross-sectional study of cats presented for routine nephrology visits. Primary outcomes included assessment of the diagnostic values of erythrocyte indices (mean corpuscular volume, hemoglobin, and hemoglobin concentration: MCV, MCH, and MCHC) and reticulocyte indices (mean corpuscular volume, MCVr; corpuscular hemoglobin, CHr), using TSAT as reference.

Results: Iron deficiency was diagnosed in 9/64 cats (14%). A receiver-operating characteristic curve analysis yielded a moderate discriminatory value for CHr in this diagnosis: area under the curve [AUC] = .75 (95% confidence interval, 0.48-0.89); P = .006; sensitivity 67%, specificity 82% for a cutoff of 15.9 pg. This compared favorably to MCVr (AUC = .63; P = .29), MCV (AUC = .58; P = .45), MCH (AUC = .64; P = .19), and MCHC (AUC = .7; P = .03).

Conclusion and clinical importance: CHr added moderate value to the diagnosis of iron deficiency in cats with CKD.

Keywords: CHr; MCVr; iron deficiency; serum iron concentration; transferrin saturation.

Publication types

  • Observational Study, Veterinary

MeSH terms

  • Anemia, Iron-Deficiency* / diagnosis
  • Anemia, Iron-Deficiency* / veterinary
  • Animals
  • Cat Diseases* / diagnosis
  • Cats
  • Cross-Sectional Studies
  • Erythrocyte Indices / veterinary
  • Hemoglobins / analysis
  • Iron
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / veterinary
  • Reticulocytes / chemistry

Substances

  • Hemoglobins
  • Iron