The effects of recombinant human erythropoietin on functional health and well-being in chronic dialysis patients.
As a component of the open-label, multicenter National Cooperative Recombinant Human Erythropoietin (Epo) Study, the health-related quality-of-life effects of Epo therapy were assessed in 484 dialysis patients who had not previously been treated with Epo therapy (New-to-Epo) and 520 dialysis patients who were already receiving Epo therapy at the time of study enrollment (Old-to-Epo). Using scales from the Medical Outcomes Study 36-item Short Form Health Survey (SF-36), health-related quality of life was assessed on study enrollment (baseline) and at an average of 99 days follow-up. At baseline, SF-36 scores for Old- and New-to-Epo patients were well below those observed in the general population, reflecting substantial impairments in functional status and well-being among patients with chronic renal failure. Significant improvements from baseline to follow-up were observed among New-to-Epo patients in vitality, physical functioning, social functioning, mental health, looking after the home, social life, hobbies, and satisfaction with sexual activity (P < 0.05 for each). The mean improvements in hematocrit values among New-to-Epo and Old-to Epo patients were 4.6 and 0.3, respectively. At the time of follow-up, SF-36 scores for New-to-Epo patients were comparable with those observed among Old-to-Epo patients, whose scores did not change significantly from baseline to follow-up. Analysis of the relationship between Epo therapy, hematocrit values, and health-related quality of life suggest that some of the beneficial quality-of-life effects of Epo are mediated through a change in hematocrit level.
Beusterien
K M
KM
Health Technology Associates, Inc., Washington, DC 20005-3934, USA.
Nissenson
A R
AR
Port
F K
FK
Kelly
M
M
Steinwald
B
B
Ware
J E
JE
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000740:Anemia / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology / Q000534:rehabilitation; D015897:Comorbidity; D003866:Depressive Disorder / Q000523:psychology; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000523:psychology; D006400:Hematocrit; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010530:Peritoneal Dialysis / Q000009:adverse effects; D011788:Quality of Life; D044469:Racial Groups; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000009:adverse effects; D012647:Self-Assessment
D011994:Recombinant Proteins; D004921:Erythropoietin