Haemoglobin levels and health-related quality of life in young and elderly patients on specialized predialysis care

In predialysis patients, the optimal treatment choices for controlling haemoglobin (Hb) are unknown, because targeting high Hb levels has negative effects--poorer survival--but possible positive effects as well--better health-related quality of life (HRQOL). Moreover, these effects may be different...

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Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2014-07, Vol.29 (7), p.1391-1398
Main Authors: de Goeij, Moniek C M, Meuleman, Yvette, van Dijk, Sandra, Grootendorst, Diana C, Dekker, Friedo W, Halbesma, Nynke
Format: Article
Language:English
Subjects:
Age Factors
Aged
Anemia - metabolism
Anemia - prevention & control
Biomarkers - blood
Erythropoietin - metabolism
Female
Follow-Up Studies
Glomerular Filtration Rate
Hemoglobins - metabolism
Humans
Kidney Diseases - blood
Kidney Diseases - psychology
Kidney Diseases - therapy
Male
Middle Aged
Prognosis
Prospective Studies
Quality of Life - psychology
Renal Dialysis
Surveys and Questionnaires
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cited_by cdi_FETCH-LOGICAL-c323t-c00bf4271e7789615889940545366619132171ac8345d1b48676ea520571ca993
cites cdi_FETCH-LOGICAL-c323t-c00bf4271e7789615889940545366619132171ac8345d1b48676ea520571ca993
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container_issue 7
container_start_page 1391
container_title Nephrology, dialysis, transplantation
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creator de Goeij, Moniek C M
Meuleman, Yvette
van Dijk, Sandra
Grootendorst, Diana C
Dekker, Friedo W
Halbesma, Nynke
description In predialysis patients, the optimal treatment choices for controlling haemoglobin (Hb) are unknown, because targeting high Hb levels has negative effects--poorer survival--but possible positive effects as well--better health-related quality of life (HRQOL). Moreover, these effects may be different in specific subgroups (e.g. young versus elderly). In the PREPARE-2 follow-up study, incident predialysis patients were included (2004-2011) when referred to 1 of the 25 participating Dutch outpatient clinics. HRQOL was assessed at 6-month intervals with the short form-36 (SF-36) questionnaire [physical/mental summary measure and eight subscales (range 0-100)]. A linear mixed model was used to associate Hb [
doi_str_mv 10.1093/ndt/gft533
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Moreover, these effects may be different in specific subgroups (e.g. young versus elderly). In the PREPARE-2 follow-up study, incident predialysis patients were included (2004-2011) when referred to 1 of the 25 participating Dutch outpatient clinics. HRQOL was assessed at 6-month intervals with the short form-36 (SF-36) questionnaire [physical/mental summary measure and eight subscales (range 0-100)]. A linear mixed model was used to associate Hb [<11, ≥ 11 to <12 (reference), ≥ 12 to <13 and ≥ 13 g/dL] with HRQOL, stratified by prescription of anaemia medication (erythropoietin-stimulating agent (ESA)/iron) and age (young: <65 years and elderly: ≥ 65 years). Only elderly patients (n = 214) not prescribed ESA/iron and with a high Hb (≥ 13 versus ≥ 11 to <12 g/dL) had a statistically significant (P < 0.05) and/or clinically relevant (>3-5 points) higher physical [11.9, 95% confidence interval (CI) 1.7, 22.2] and mental (6.4, 95% CI -1.7, 14.6) summary score. High Hb was not associated with a higher HRQOL in elderly patients who were prescribed ESA/iron. However, only young patients (n = 157) prescribed ESA/iron and with a high Hb (≥ 13 versus ≥ 11 to <12 g/dL) had a higher physical (8.9, 95% CI 2.1, 15.8) and mental (6.2, 95% CI -0.4, 12.8) summary score. The association of Hb levels with HRQOL differs by age and use of ESA/iron medication on predialysis care. Therefore, medical care should aim for shared decision-making regarding the appropriate Hb target leading to more individualized care.]]></description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gft533</identifier><identifier>PMID: 24516235</identifier><language>eng</language><publisher>England</publisher><subject>Age Factors ; Aged ; Anemia - metabolism ; Anemia - prevention &amp; control ; Biomarkers - blood ; Erythropoietin - metabolism ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Hemoglobins - metabolism ; Humans ; Kidney Diseases - blood ; Kidney Diseases - psychology ; Kidney Diseases - therapy ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Quality of Life - psychology ; Renal Dialysis ; Surveys and Questionnaires</subject><ispartof>Nephrology, dialysis, transplantation, 2014-07, Vol.29 (7), p.1391-1398</ispartof><rights>The Author 2014. 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Moreover, these effects may be different in specific subgroups (e.g. young versus elderly). In the PREPARE-2 follow-up study, incident predialysis patients were included (2004-2011) when referred to 1 of the 25 participating Dutch outpatient clinics. HRQOL was assessed at 6-month intervals with the short form-36 (SF-36) questionnaire [physical/mental summary measure and eight subscales (range 0-100)]. A linear mixed model was used to associate Hb [<11, ≥ 11 to <12 (reference), ≥ 12 to <13 and ≥ 13 g/dL] with HRQOL, stratified by prescription of anaemia medication (erythropoietin-stimulating agent (ESA)/iron) and age (young: <65 years and elderly: ≥ 65 years). Only elderly patients (n = 214) not prescribed ESA/iron and with a high Hb (≥ 13 versus ≥ 11 to <12 g/dL) had a statistically significant (P < 0.05) and/or clinically relevant (>3-5 points) higher physical [11.9, 95% confidence interval (CI) 1.7, 22.2] and mental (6.4, 95% CI -1.7, 14.6) summary score. 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High Hb was not associated with a higher HRQOL in elderly patients who were prescribed ESA/iron. However, only young patients (n = 157) prescribed ESA/iron and with a high Hb (≥ 13 versus ≥ 11 to <12 g/dL) had a higher physical (8.9, 95% CI 2.1, 15.8) and mental (6.2, 95% CI -0.4, 12.8) summary score. The association of Hb levels with HRQOL differs by age and use of ESA/iron medication on predialysis care. Therefore, medical care should aim for shared decision-making regarding the appropriate Hb target leading to more individualized care.]]></abstract><cop>England</cop><pmid>24516235</pmid><doi>10.1093/ndt/gft533</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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1460-2385
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source Oxford Journals Online
subjects Age Factors
Aged
Anemia - metabolism
Anemia - prevention & control
Biomarkers - blood
Erythropoietin - metabolism
Female
Follow-Up Studies
Glomerular Filtration Rate
Hemoglobins - metabolism
Humans
Kidney Diseases - blood
Kidney Diseases - psychology
Kidney Diseases - therapy
Male
Middle Aged
Prognosis
Prospective Studies
Quality of Life - psychology
Renal Dialysis
Surveys and Questionnaires
title Haemoglobin levels and health-related quality of life in young and elderly patients on specialized predialysis care
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