Clinical performance targets and quality of life in hemodialysis patients.
OBJECTIVE
Patients value health-related quality of life (HRQOL) over survival. It was our aim to study the relation between attainment of widely accepted performance targets and HRQOL in hemodialysis patients.


METHODS
This study included baseline data from 715 hemodialysis patients from 29 dialysis centers. Six clinical performance targets, as recommended by the Kidney Disease Outcomes Quality Initiative (KDOQI), were evaluated: single-pool Kt/V (≥1.2), hemoglobin (11-13 g/dl), vascular access (fistula), phosphorus (2.3-4.5 mg/dl), parathyroid hormone (150-300 pg/ml), and blood pressure (predialysis <140/90 and postdialysis <130/ 80 mm Hg).


RESULTS
After correction for case-mix and multiple comparisons, no association was found between the 6 KDOQI clinical performance targets and the 14 HRQOL domains, or between the number of performance targets reached and HRQOL.


CONCLUSIONS
Attainment with widely accepted clinical performance targets was not related to the HRQOL of hemodialysis patients. Hence, in clinical guidelines, HRQOL should be adopted as an explicit treatment goal for these individuals.
Department of Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands.
Albert H A
AH
Mazairac
G Ardine
GA
de Wit
Muriel P C
MP
Grooteman
E Lars
EL
Penne
Neelke C
NC
van der Weerd
Claire H
CH
den Hoedt
Renée
R
Lévesque
Marinus A
MA
van den Dorpel
Menso J
MJ
Nubé
Piet M
PM
Ter Wee
Peter J
PJ
Blankestijn
Michiel L
ML
Bots
D000368:Aged; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D007674:Kidney Diseases / Q000378:metabolism / Q000473:pathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010758:Phosphorus / Q000097:blood; D011788:Quality of Life; D006435:Renal Dialysis / Q000523:psychology
D006454:Hemoglobins; D010758:Phosphorus