HNY Policy and Pathway Repository - North Yorkshire

Raised HCT [not raised Hb]:

• >0.48 in females
• >0.52 in males

None provided

Repeat FBC in 2-4 weeks with good hydration 24 hours prior to ensure not dehydrated at time of sampling.
 

Consider

• Relative polycythaemia (reduced plasma volume, normal red cell mass):
  • Dehydration
  • Diuretics
  • Excess OH consumption
  • Smoking
• Absolute polycythaemia (increased red cell mass):
  • Central hypoxia - e.g. chronic lung diseases, OSA
  • Local renal hypoxia - renal artery stenosis, end stage renal disease, hydronephrosis, PKD
  • EPO secreting tumour
  • Polycythaemia vera (rare)
• Implicated medications:
  • Diuretics
  • Androgens
  • EPO
• Other:
  • Post renal transplant
  • Smoking (multifactorial)

Refer urgently to haematology if:

• Recent thrombosis
• Neurological disturbance, visual symptoms
• Bleeding
• HCT >0.6

Consider routine referral to haematology if: 

• Cause not apparent
• If there is a clear secondary cause (e.g. hypoxia from COPD or OSA, management is optimising the management of the underlying cause).

• Harrogate and District