Abstract: TH-PO876
Impact of Changes in Hemoglobin on Health-Related Quality of Life in Dialysis Patients
Session Information
- Anemia and Iron Metabolism
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Anemia and Iron Metabolism
- 200 Anemia and Iron Metabolism
Authors
- van Lieshout, Thomas Sebastiaan, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, Netherlands
- Driehuis, Esmee, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, Netherlands
- Mahic, Osman, Universitair Medisch Centrum Utrecht, Utrecht, Utrecht, Netherlands
- van Jaarsveld, Brigit C., Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, Netherlands
- Abrahams, Alferso C., Universitair Medisch Centrum Utrecht, Utrecht, Utrecht, Netherlands
Group or Team Name
- DOMESTICO Study Group.
Background
Anemia is a common complication among dialysis patients and has a negative impact on health-related quality of life (HRQoL). Higher levels of hemoglobin (Hb) are associated with better HRQoL but also with an increased risk of adverse events like stroke. The optimal target level for Hb remains subject of debate and an individual approach is proposed. To develop this, changes in Hb are of additional importance. However, the impact of changes in Hb levels on HRQoL are unclear. Therefore, we investigate the impact of changes in Hb on HRQoL during the first 24 months of dialysis.
Methods
Dialysis patients (n=1718), included in the prospective Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes (DOMESTICO), were studied. Change in Hb was categorized into no change (-0.5; 0.5 g/dL), small increase (0.5; 2.0 g/dL), large increase (> 2.0 g/dL), small decrease (-2.0; -0.5 g/dL), and large decrease (<-2.0 g/dL). HRQoL was measured with the 12-item Short Form Health Survey (SF-12), containing two summary scores, reflecting physical and mental HRQoL. Data were analyzed using linear mixed models and generalized linear models, both adjusted for confounders.
Results
Mean age at initiation was 63.8 years (SD 14.5) and 75.3% of the patients started with hemodialysis. The mean Hb level during the first 24 months of dialysis was 10.8 g/dL (SD 1.6). Patients with an increase or decrease in Hb showed no difference in physical HRQoL compared to patients with stable Hb over time (Figure 1). A large decrease in Hb was associated with lower mental HRQoL over time, with a mean difference of -1.01 (95% CI -1.65;-0.36). An increase of Hb did not impact mental HRQoL (Figure 1).
Conclusion
This study shows that a decrease in Hb has a negative impact on mental HRQoL compared to no change in Hb. Hb changes were not associated with physical HRQoL. These findings indicate that physicians should not focus on increasing Hb levels but rather on preventing a decrease when it comes to HRQoL. Such an approach could help in adjusting present guidelines with the goal to induce less adverse events and improve cost-effectiveness.