{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:01:02Z","timestamp":1784700062850,"version":"3.55.0"},"reference-count":11,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Iron deficiency is common in patients receiving haemodialysis and contributes to adverse outcomes. Conventional iron biomarkers, including ferritin and transferrin saturation (TSAT), have limitations and may be less accessible in some settings. Reticulocyte haemoglobin equivalent (RET\u2010He) is a lower\u2010cost, potentially more accessible marker for detection of iron deficiency. This study evaluated whether RET\u2010He\u2010guided intravenous iron supplementation is non\u2010inferior to TSAT\u2010guided supplementation in haemodialysis patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this randomized non\u2010inferiority trial, 160 haemodialysis patients were randomized to a TSAT\u2010guided group (\n n<\/jats:italic>\n \u2009=\u200979) or RET\u2010He\u2010guided group (\n n<\/jats:italic>\n \u2009=\u200981). Intravenous iron was administered in both groups according to prespecified protocols. The primary outcome was the erythropoietin resistance index (ERI) at 3 and 6\u2009months. RET\u2010He guidance was considered non\u2010inferior if the upper bound of the 95% confidence interval (CI) for the between\u2010group mean difference was \u2264\u2009160\u2009units\/week\/g\/dL. Secondary outcomes included all\u2010cause mortality, hospitalization, cardiovascular events, blood transfusion, and infection.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Baseline characteristics were comparable between groups. RET\u2010He\u2010guided supplementation was non\u2010inferior to TSAT\u2010guided supplementation for ERI at 3\u2009months (mean difference, \u221235.92; 95% CI, \u2212155.60 to 90.29;\n p<\/jats:italic>\n \u2009=\u20090.001 for non\u2010inferiority) and 6\u2009months (mean difference, \u221239.68; 95% CI, \u2212187.01 to 107.64;\n p<\/jats:italic>\n \u2009=\u20090.004 for non\u2010inferiority). The RET\u2010He group received significantly lower cumulative intravenous iron doses. Secondary outcomes did not differ significantly, although the trial was not powered for these clinical outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n RET\u2010He\u2010guided intravenous iron supplementation was non\u2010inferior to TSAT\u2010guided supplementation for reducing ERI over 6\u2009months. Use of RET\u2010He may offer a lower\u2010cost and more accessible strategy for anaemia management in haemodialysis patients, particularly in resource\u2010limited settings.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nep.70247","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T04:31:27Z","timestamp":1784608287000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Reticulocyte Haemoglobin Equivalent\u2010Guided Versus Transferrin Saturation\u2010Guided Iron Supplement Protocol in Haemodialysis Patients: A Multicenter Cluster Randomized Controlled Trial"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6441-8389","authenticated-orcid":false,"given":"Chalermchon","family":"Suttaluang","sequence":"first","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3524-6292","authenticated-orcid":false,"given":"Jeerath","family":"Phannajit","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand"},{"name":"Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine Chulalongkorn University Bangkok Thailand"},{"name":"Division of Clinical Epidemiology, Department of Medicine, King Chulalongkorn Memorial Hospital Thai Red Cross Society Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monchai","family":"Siribamrungwong","sequence":"additional","affiliation":[{"name":"Department of Medicine Lerdsin General Hospital Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamonrat","family":"Chongthanakorn","sequence":"additional","affiliation":[{"name":"Department of Medicine Charoenkrung Pracharak Hospital Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songkiat","family":"Lewsuwan","sequence":"additional","affiliation":[{"name":"Department of Medicine Boonyavej Hospital Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8779-500X","authenticated-orcid":false,"given":"Pisut","family":"Katavetin","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand"},{"name":"Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine Chulalongkorn University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5718-3843","authenticated-orcid":false,"given":"Yingyos","family":"Avihingsanon","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2846-9498","authenticated-orcid":false,"given":"Kearkiat","family":"Praditpornsilpa","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somchai","family":"Eiam\u2010Ong","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6236-8893","authenticated-orcid":false,"given":"Kullaya","family":"Takkavatakarn","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand"},{"name":"Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine Chulalongkorn University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9813-9219","authenticated-orcid":false,"given":"Paweena","family":"Susantitaphong","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital Bangkok Thailand"},{"name":"Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine Chulalongkorn University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.07.032"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11195675"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1515\/rjim-2016-0003"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-017-2212-6"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1810742"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0050295"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2054358120933397"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2014.275"},{"key":"e_1_2_9_10_1","unstructured":"Thailand Tnso \u201cGuidelines for the Management of Anemia in Chronic Kidney Disease \u201d2021."},{"issue":"4","key":"e_1_2_9_11_1","first-page":"315","article-title":"Dose Equivalence Between Continuous Erythropoietin Receptor Activator (CERA), Darbepoetin and Epoetin in Patients With Advanced Chronic Kidney Disease","volume":"18","author":"Vega 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History"}},{"value":"2026-07-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70247"}}