Relation between level or change of hemoglobin and generic and disease-specific quality of life measures in hemodialysis.
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 > or = 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 > or = 11 g/dl, have better QOL at 1 year, with regard to important physical, mental, social, and cognitive domains.
Plantinga
Laura C
LC
Welch Center for Prevention, Epidemiology and Clinical Research, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA. lplantin@jhsph.edu
Fink
Nancy E
NE
Jaar
Bernard G
BG
Huang
I-Chan
IC
Wu
Albert W
AW
Meyer
Klemens B
KB
Powe
Neil R
NR
D000740:Anemia / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011581:Psychological Tests; D011788:Quality of Life; D006435:Renal Dialysis / Q000523:psychology*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States
D006454:Hemoglobins