Abstract
Objective
We sought to examine the relation between meeting or exceeding the current minimum guideline for hemoglobin (11 g/dl) in dialysis patients and generic and disease-specific QOL scores at 1 year.
Methods
In 438 incident hemodialysis patients from a national prospective cohort study, we used regression models to predict QOL score (all scaled 0–100) at 1 year using 6-month values of hemoglobin, adjusting for potential confounders.
Results
Compared to values <11 g/dl, hemoglobin ≥11 g/dl at 6 months was associated with higher scores for the general domains of physical functioning, role physical, mental health, social functioning, and bodily pain at 1 year; cognitive function, diet restriction, and dialysis access dialysis-specific domain scores were also higher for these patients. Each 1 g/dl greater hemoglobin was also statistically significantly associated with higher QOL scores for most domains. In longitudinal analyses, most of the domains showed that, with each 1 g/dl increase in hemoglobin concentration from baseline to 6 months, QOL score increased significantly over the first year.
Conclusions
Hemodialysis patients who attain higher hemoglobin concentration at 6 months, especially ≥11 g/dl, have better QOL at 1 year, with regard to important physical, mental, social, and cognitive domains.
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Abbreviations
- QOL:
-
Quality of life
- KDOQI:
-
Kidney Disease Outcomes Quality Initiative
- CHOICE:
-
Choices for Healthy Outcomes in Caring for End-Stage Renal Disease
- CHEQ:
-
CHOICE Health Experience Questionnaire
- PCS:
-
Physical component summary
- MCS:
-
Mental component summary
- BMI:
-
Body mass index
- ICED:
-
Index of Coexistent Disease
- USRDS:
-
United States Renal Data System
- CMS:
-
Centers for Medicare & Medicaid Services.
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Acknowledgments
We thank the patients, staff, and medical directors of the participating clinics at DCI and St. Raphael’s Hospital who contributed to the study. This study was presented in part at the 2005 American Society of Nephrology Annual Meeting in Philadelphia, Pennsylvania. Some of the data reported here have been supplied by the United States Renal Data System (USRDS). The interpretation and reporting of these data are the responsibility of the authors and in no way should be seen as an official policy or interpretation of the U.S. government. This work was supported by grant no. RO1 DK 59616 from the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, grant no. R01-HS-08365 from the Agency for Health Care Research and Quality, Rockville, Maryland and grant no. R01 HL 62985 from the National Heart Lung and Blood Institute, Bethesda, MD. Dr. Powe is supported by grant K24DK02643 from the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD. Dr. Jaar is supported by a Clinician Scientist Award from the Johns Hopkins School of Medicine.
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Plantinga, L., Fink, N., Jaar, B. et al. Relation between level or change of hemoglobin and generic and disease-specific quality of life measures in hemodialysis. Qual Life Res 16, 755–765 (2007). https://doi.org/10.1007/s11136-007-9176-6
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DOI: https://doi.org/10.1007/s11136-007-9176-6