Hemoglobin Affects Quality of Life in CKD

For CKD patients, higher hemoglobin levels are associated with higher scores on measures of health-related quality of life, according to a report in the Clinical Journal of the American Society of Nephrology.

Led by Frederic O. Finkelstein, MD, of Yale University, the researchers looked at the relationship between hemoglobin and health-related quality of life in 1200 patients with stage 3 to 5 CKD. Patients with higher hemoglobin levels scored higher on several quality-of-life tests, including all physical domains of the Short Form-36 questionnaire.

On a kidney disease-specific assessment, general health score also increased with hemoglobin level. The biggest jumps in quality of life were noted at hemoglobin levels of 11 to 12 g/dL, compared to levels under 11 g/dL.

The results may help to inform the ongoing debate over the use of erythropoeisis. stimulating agents (ESAs) to treat anemia in CKD. Many nephrologists believe that ESAs improve quality of life, but previous studies of this issue are not reflected in the current guidelines for ESA use.

The authors hope that an upcoming FDA report on the use of patient-reported outcomes to assess health-related quality of life will help nephrologists address the many outstanding questions on ESA use [Finkelstein F, Story K, Firanek C, Mendelssohn D, Barre P, Takano T, Rodd K and Mujair S: Health-related quality of life and hemoglobin levels in chronic kidney disease patients. Clin J Am Soc Nephrol 2009; 4:33–38].