Predictive Value of Reticulocyte Hemoglobin Equivalent in Screening Iron Depletion Among Regular Blood Donors

Lili Novri Yanti; Zelly Dia Rofinda; Efrida Efrida; Rikarni Rikarni; Husni Husni; Elfira Yusri

doi:10.30742/jikw.v15i2.5316

Authors

Lili Novri Yanti Clinical Pathology Specialist Study Program, Faculty of Medicine, Universitas Andalas
Zelly Dia Rofinda Departemen Patologi Klinik dan Kedokteran Laboratorium, Fakultas Kedokteran Universitas Andalas
Efrida Efrida Department of Clinical Pathology, Faculty of Medicine, Universitas Andalas
Rikarni Rikarni Department of Clinical Pathology, Faculty of Medicine, Universitas Andalas
Husni Husni Department of Clinical Pathology, Faculty of Medicine, Universitas Andalas
Elfira Yusri Department of Clinical Pathology, Faculty of Medicine, Universitas Andalas

DOI:

https://doi.org/10.30742/jikw.v15i2.5316

Abstract

Background: Regular blood donors are at increased risk of iron depletion due to repeated blood loss and loss of hemoglobin-bound iron. Although hemoglobin testing can detect iron deficiency anemia, it may not identify early iron depletion. Assessment using bone marrow staining is invasive, while serum ferritin can be influenced by inflammation, highlighting the need for a practical and reliable alternative. Objective: This study aimed to evaluate the predictive value of Ret-He for detecting iron depletion in regular blood donors. Methods: An analytical cross-sectional study was conducted involving 168 regular blood donors at the Blood Centre of M. Djamil Hospital, Padang, from August to October 2025. Ret-He and serum ferritin levels were measured using flow cytometry and Enzyme-Linked Fluorescence Assay (ELFA), respectively. The diagnostic performance and optimal cut-off point of Ret-He were evaluated utilizing Receiver Operating Characteristic (ROC) curve analysis. Result: The study cohort was a median age of 30 years, with a predominantly male demographic (54.8%). Iron depletion was identified as 37.5% of the donors. The median Ret-He value in iron-depleted donors was significantly lower compared to non-depleted donors (30.8 pg vs. 32.1 pg; p<0.001). ROC analysis established an optimal Ret-He cut-off point of <31.75 pg, yielding an Area Under the Curve (AUC) of 0.702, alongside a sensitivity of 73.0%, specificity of 60.0%, positive predictive value (PPV) of 52.3%, and negative predictive value (NPV) of 78.8%. Conclusion: Reticulocyte Hemoglobin Equivalent with cut-off point of <31.75 pg demonstrates moderate predictive ability in screening iron depletion among regular blood donors.

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