Anemia and health-related quality of life in adolescents with chronic kidney disease.
BACKGROUND
A number of studies of adults with chronic kidney disease (CKD) have shown a negative impact of anemia on several aspects of health-related quality of life (HRQOL). Although similar links have been suggested in adolescent dialysis populations, the relationship between anemia and HRQOL in children not requiring dialysis therapy has yet to be studied extensively in a large sample.


METHODS
We examined the association between anemia and HRQOL in baseline data collected on a prospective cohort of adolescents with CKD by using a generic HRQOL questionnaire completed by parents or caregivers (Child Health Questionnaire Parent Form [CHQ-PF50]). Our study population included guardians or caregivers of 105 adolescents (mean age, 14 +/- 2 years) with stages 1 to 5 CKD as defined by the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative, including subjects with chronic renal insufficiency, patients with functioning kidney transplants, and dialysis patients.


RESULTS
Seventy of 105 patients were classified in the study as anemic according to a hematocrit value of 36% or less. Compared with the group with higher hematocrit values and independent of sex, race, and estimated glomerular filtration rate, anemic patients reported greater limitations in CHQ-PF50 domains relating to (1) physical functioning, (2) limitations in schoolwork or activities with friends as a result of physical health, and (3) parental impact in time and family activities.


CONCLUSIONS
Anemia was associated with lower quality of life in adolescents across the spectrum of stages of CKD. Future studies should address the effect of interventions to improve anemia on HRQOL.
Gerson
Arlene
A
Department of Pediatrics, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Hwang
Wenke
W
Fiorenza
Jeffrey
J
Barth
Katherine
K
Kaskel
Frederick
F
Weiss
Lynne
L
Zelikovsky
Nataliya
N
Fivush
Barbara
B
Furth
Susan
S
D000293:Adolescent; D000740:Anemia / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000473:pathology*; D008297:Male; D011446:Prospective Studies; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires