Negative effects of anemia on quality of life and its improvement by complete correction of anemia by administration of recombinant human erythropoietin in posttransplant patients.
BACKGROUND
Anemia is a common complication in posttransplant patients (posttransplant anemia: PTA). We tested the hypothesis that targeting hemoglobin (Hb) over 13.3 g/dl by administration of recombinant human erythropoietin (rHuEPO-ad) has positive impact on quality of life (QOL).


METHODS
Twenty-four patients, whose initial Hb and estimated glomerular filtration rate (eGFR) were 10.5 +/- 0.2 g/dl and 48.5 +/- 2.7 ml/(min 1.73 m2), respectively, were enrolled in the present study. Physical and mental QOL in these patients before and after rHuEPO-ad were acquired and summarized as physical summary sore (PSC) and mental summary sore (MSC), respectively, by the 36-item Short Form (SF-36), an international questionnaire for analysis of QOL.


RESULTS
Before rHuEPO-ad, posttransplant patients had preserved MSC (54.1 +/- 2.3) but impaired PSC (32.6 +/- 3.2). rHuEPO-ad for 6 months increased their Hb to 13.7 +/- 0.3 g/dl. This was accompanied by improvement of PSC (49.1 +/- 2.1: P < 0.01 versus before rHuEPO-ad). MSC was preserved during rHuEPO-ad (54.4 +/- 1.6: NS versus before rHuEPO-ad). There was inverse correlation between initial PSC or MSC and responses of these parameters to rHuEPO-ad (PSC, P = 0.007; MSC, P = 0.009). Patients whose initial PSC was lower than 39.6 or whose initial MSC was lower than 39.4 were expected to improve their PSC or MSC by more than 10 by rHuEPO-ad.


CONCLUSIONS
Anemia in posttransplant patients has negative impacts on their QOL. Scoring mental and physical QOL by SF-36 in posttransplant patients is useful to identify groups of patients whose QOL could be improved by rHuEPO-ad.
Kawada
Noritaka
N
Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
Moriyama
Toshiki
T
Health Care Center, Osaka University, 1-17 Machikaneyama-cho, Toyonaka, Osaka, 560-0043, Japan. moriyama@wellness.hss.osaka-u.ac.jp.
Ichimaru
Naotsugu
N
Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan.
Imamura
Ryoichi
R
Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan.
Matsui
Isao
I
Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
Takabatake
Yoshitsugu
Y
Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
Nagasawa
Yasuyuki
Y
Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
Isaka
Yoshitaka
Y
Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Osaka, Japan.
Kojima
Yasuyuki
Y
Takahashi Clinic, Tokyo, Japan.
Kokado
Yukito
Y
Soryukai Inoue Hospital, Suita, Japan.
Rakugi
Hiromi
H
Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
Imai
Enyu
E
Department of Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan.
Takahara
Shiro
S
Department of Advanced Technology for Transplantation, Osaka University Graduate School of Medicine, Osaka, Japan.
D000328:Adult; D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D015415:Biomarkers / Q000097:blood; D003401:Creatine / Q000097:blood; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005919:Glomerular Filtration Rate; D006397:Hematinics / Q000627:therapeutic use*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D011994:Recombinant Proteins; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D003401:Creatine