SERUM HEMOGLOBIN LEVEL AND QUALITY OF LIFE IN END STAGE RENAL DISEASE
Anemia is one of the most important complications of end stage renal disease. Aim: To evaluate the prevalence of uremic anemia (UA) and its impact on quality of life (QoL) in hemodialysis (HD) patients. Material and methods: We performed a one-month (October 2015) prospective cross-sectional observational study in a single hemodialysis unit in Romania which included a total of 243 patients on regular three hemodialysis sessions per week. QoL was measured using a RAND 36-Item Short Form Health Survey (version 1.0). Blood samples (hematocrit, hemoglobin, ferritin, transferrin saturation, C-reactive protein) were collected before HD session. Results: The prevalence of UA in our study was 61.3%. Mean serum hemoglobin was 10.86±1.46 g/dL and its level had not a significant impact on any of the SF-36 scales. Conclusions: Our study shows lower scores in all QoL domains in the presence of UA, but only by up to 7 units. This finding inconsistent with other studies is probably due to the fact that in our study the recorded serum ferritin, transferrin saturation and hemoglobin levels were within the reference range recommended by Kidney Disease Improving Global Outcomes guidelines, levels rarely associated with adverse events in people with kidney disease.
2. Tannor EK, Norman BR, Adusei KK, Sarfo FS, Davids MR, Bedu-Addo G. Quality of life among patients with moderate to advanced chronic kidney disease in Ghana - a single center study. BMC Nephrol 2019; 20(1): 122.
3. Palaka E, Grandy S, Van haalen H, Mcewan P, Darlington O. The Impact of CKD Anemia on Patients: Incidence, Risk Factors, and Clinical Outcomes-A Systematic Literature Review. Int J Nephrol 2020; 2020: 7692376.
4. Bowry SK, Gatti E. Impact of hemodialysis therapy on anemia of chronic kidney disease: the potential mechanisms. Blood Purif 2011; 32(3): 210-219.
5. Lovcić V, Vujić J, Ivanac janković R, et al. Treatment anemia of chronic kidney disease in predialysis patients (stage 1-4). Acta Med Croatica 2009; 63 (1): 11-16.
6. Wish JB. The economic realities of erythropoiesis-stimulating agent therapy in kidney disease. Kidney Int 2006; 70: S21–S25.
7. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual frame-work and item selection. Med Care 1992; 30(6): 473-483.
8. Santos PR. Current Anemia Treatment in Hemodialysis Patients: The Challenge for Secure Use of Erythropoietin Stimulating Agents. In: Suzuki H editor. Hemodialysis InTech 2013.
9. Jacobson LO, Goldwasser E, Fried W, Plzak L. Role of the kidney in erythropoiesis. Natur 1957; 179: 633-634.
10. Bsarab A, Ayyoub F. Anemia in renal disease. In: Schrier RW(ed). Diseases of the Kidney and Uri-nary Tract, 8th Ed., Philadelphia, Lippincott Williams and Wilkins, 2007; 2406-2430.
11. Jones SC, Smith D, Nag S, et al. Prevalence and nature of anemia in a prospective, population-based sample of people with diabetes: Teesside anemia in diabetes (TAD) study. Diabet Med 2010; 27(6): 655-659.
12. Stauffer ME, Fan T. Prevalence of anemia in chronic kidney disease in the United States. PLoS ONE 2014; 9(1): e84943.
13. Idris I, Tohid H, Muhammad NA, et al. Anemia among primary care patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD): a multicentered cross-sectional study. BMJ Open 2018; 8(12): e025125.
14. Li Y, Shi H, Wang WM, et al. Prevalence, awareness, and treatment of anemia in Chinese patients with non-dialysis chronic kidney disease: First multicenter, cross-sectional study. Medicine 2016; 95 (24): e3872.
15. New JP, Aung T, Baker PG, et al. The high prevalence of unrecognized anemia in patients with dia-betes and chronic kidney disease: a population-based study. Diabet Med 2008; 25(5): 564-569.
16. Eckardt KU. Erythropoietin: oxygen-dependent control of erythropoiesis and its failure in renal disease. Nephron 1994; 67(1): 7-23.
17. Pisoni RL, Bragg-Gresham JL, Young EW, et al. Anemia management and outcomes from 12 countries in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis 2004; 44(1): 94-111.
18. KDIGO. Kidney disease: Improving Global Outcomes Anemia work group. KDIGO Clinical practice guidelines for anemia in chronic kidney disease. Kidney Int Suppl 2012; 2: 279-335.
19. Locatelli F, Eckardt K. Cardiovascular risk reduction in early anemia trial with epoetin beta investigators and coordinators. Curr Med Res Opin 2010; 26: 2543-2552.
20. Donciu MD, Tasmoc A, Dumea R, et al. A cross-sectional study regarding the impact of end stage renal disease on quality of life. Rev Chir Soc Med Nat Iasi 2013; 117(4): 908-915.
21. Akel M, Shamas K, Sakr F, et al. Evaluation of the management of anemia in hemodialysis patients in Lebanon. J Nephropharmacol 2017; 6(2): 68-73.
22. Coyne DW, Kapoian T, Suki W, et al. Ferric gluconate is highly efficacious in anemic hemodialysis patients with high serum ferritin and low transferrin saturation: results of the Dialysis Patients' Re-sponse to IV Iron with Elevated Ferritin (DRIVE) Study. J Am Soc Nephrol 2007; 17: 975-984.
23. Kapoian T, O'Mara NB, Singh AK, et al. Ferric gluconate reduces epoetin requirements in hemodialysis patients with elevated ferritin. J Am Soc Nephrol 2008; 19: 372-379.
24. Tasmoc A, Hogas S, Siriopol D, Onofriescu M. Validation and Evaluation of memorial symptoms assessment scale short-form (MSAS-SF) in a Romanian cohort of hemodialysis patients. Rev Med Chir Soc Med Nat Iasi 2015; 119(3): 670-675.
25. Kishore Kumar B, Vijai Anand Babu B. Quality of Life in Relation to Severity of Anemia in End Stage Renal Disease Patients on Maintenance Hemodialysis. App Med Sci 2015; 3(1G): 482-486.
26. Mehdi U, Toto RD. Anemia, diabetes, and chronic kidney disease. Diabetes Care 2009; 32(7): 1320-1326.
27. Covic A. Hemodializa. Principii teoretice și practice. Romania, Iasi: Casa Editorială Demiurg Plus, 2011, 625-635.
28. Mezzano S, Droguett A, Burgos ME, et al. Renin-angiotensin system activation and interstitial in-flammation in human diabetic nephropathy. Kidney Int 2003; 64(Suppl 86): S64-S70.
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.
COPYRIGHT TRANSFER FORM FOR
REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /
THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI
We, the undersigned authors of the manuscript entitled
warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.
- we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
- the manuscript does not break the intellectual property rights of any other person.
- we have read the submitted version of the manuscript and we are fully responsible for the content.
Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):
N.B. All the authors must sign this form