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Introduction: Low hemoglobin density (LHD%) is a new parameter provided by Beckman-Coulter derived from the mean cell hemoglobin concentration, using the mathematical sigmoid transformation LHD% =100 * √1-(1/(1 + e1.8(30-MCHC))).This study investigated the reliability of LHD% for the assessment of iron status in the presence of inflammation.Methods: Healthy subjects (n =90) and patients with iron deficiency (IDA, n =110), chronic kidney disease (CKD, n =65) and anemia of chronic disease (ACD, n =85; 24 were iron deficient and 61 were iron sufficient) were analyzed on a LH 780 analyzer (Beckman Coulter Inc., Miami, FL, USA).Independent samples U test and receiver operating characteristic (ROC) curve analysis were applied.To determine the concordance between LHD% and soluble transferrin receptor (sTrR) Cohens κ index was calculated.Results: LHD % values showed no statistical difference in patients with IDA and patients with ACD accompanied with IDA (P =0.6427); LHD% values in these patients were significantly different (P< 0.0001) compared with the iron-sufficient patients with ACD.ROC analysis for LHD% in the detection of iron deficiency showed the following: area under curve 0.903; cut off 5.5%, sensitivity 88.6%,specificity 76.9%; κ index, 0.65.Conclusion: LHD% is a reliable parameter for the detection of iron deficiency in patients with anemia in the presence of inflammation.