Quality of life of patients with chronic renal allograft rejection and anemia.
BACKGROUND
The treatment with recombinant human erythropoietin (rHuEPO) of anemia associated with renal insufficiency (RI) improves the health-related quality of life (HRQOL) of those patients. The objective of this study was to evaluate the HRQOL of patients with chronic allograft nephropathy (CAN) and anemia associated to RI, and the effect of rHuEPO treatment on the HRQOL.


METHODS
This prospective study consisted of 17 kidney transplant patients with RI caused by CAN and anemia who received rHuEPO. The hemoglobin (Hb) target was 12 g/dL. Serum Hb, hematocrit (Hct) and creatinine clearance (CrCl) were collected. HRQOL was evaluated with the Kidney Disease Quality of Life Short-Form 36 (SF-36) questionnaire at the start, at the 3rd and 6th month and at the end of the follow-up. SF-36 scores (eight scales, physical component summary (PCS) and mental component summary (MCS) were standardized by age and gender using the Spanish population norms. The "effect size" was also calculated for each score.


RESULTS
Hb and Hct statistically improved from the start to the 3rd month and to the end of the study (p<0.01). Although the CrCl remained stable during most of the follow-up, it worsened (p=0.002) around the 13th month. SF-36 scores at the beginning were worse than that of the general population. Three SF-36 scales statistically improved; role-physical, vitality and mental health. The effect size was moderate for pain (0.41), role-emotional (0.39) and MCS (0.42); and large for role-physical (0.65), vitality (0.81) and mental health (0.74).


CONCLUSIONS
The poor HRQOL of patients with CAN and anemia improves with rHuEPO treatment, the effect size varying from moderate to large.
Rebollo
Paolo
P
Health Outcomes Research Unit, Nephrology Unit-1, University Hospital of Asturias and Institute Reina Sofía for Nephrological Research of the FRIAT, Oviedo, Spain. pablo@hca.es
Baltar
José M
JM
Campistol
Josep M
JM
Ortega
Teresa
T
Ortega
Francisco
F
D000328:Adult; D000367:Age Factors; D000747:Anemia, Hypochromic / Q000175:diagnosis / Q000188:drug therapy*; D002908:Chronic Disease; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection; D006454:Hemoglobins / Q000187:drug effects; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D011994:Recombinant Proteins; D051437:Renal Insufficiency / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D018434:Sickness Impact Profile; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome
D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin