Negative effects of anemia on quality of life and its improvement by complete correction of anemia by administration of recombinant human erythropoietin in posttransplant patients

Clin Exp Nephrol. 2009 Aug;13(4):355-360. doi: 10.1007/s10157-009-0170-x. Epub 2009 Apr 8.

Abstract

Background: Anemia is a common complication in posttransplant patients (posttransplant anemia: PTA). We tested the hypothesis that targeting hemoglobin (Hb) over 13.3 g/dl by administration of recombinant human erythropoietin (rHuEPO-ad) has positive impact on quality of life (QOL).

Methods: Twenty-four patients, whose initial Hb and estimated glomerular filtration rate (eGFR) were 10.5 +/- 0.2 g/dl and 48.5 +/- 2.7 ml/(min 1.73 m2), respectively, were enrolled in the present study. Physical and mental QOL in these patients before and after rHuEPO-ad were acquired and summarized as physical summary sore (PSC) and mental summary sore (MSC), respectively, by the 36-item Short Form (SF-36), an international questionnaire for analysis of QOL.

Results: Before rHuEPO-ad, posttransplant patients had preserved MSC (54.1 +/- 2.3) but impaired PSC (32.6 +/- 3.2). rHuEPO-ad for 6 months increased their Hb to 13.7 +/- 0.3 g/dl. This was accompanied by improvement of PSC (49.1 +/- 2.1: P < 0.01 versus before rHuEPO-ad). MSC was preserved during rHuEPO-ad (54.4 +/- 1.6: NS versus before rHuEPO-ad). There was inverse correlation between initial PSC or MSC and responses of these parameters to rHuEPO-ad (PSC, P = 0.007; MSC, P = 0.009). Patients whose initial PSC was lower than 39.6 or whose initial MSC was lower than 39.4 were expected to improve their PSC or MSC by more than 10 by rHuEPO-ad.

Conclusions: Anemia in posttransplant patients has negative impacts on their QOL. Scoring mental and physical QOL by SF-36 in posttransplant patients is useful to identify groups of patients whose QOL could be improved by rHuEPO-ad.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Anemia / blood
  • Anemia / drug therapy*
  • Anemia / etiology
  • Anemia / physiopathology
  • Anemia / psychology
  • Biomarkers / blood
  • Creatine / blood
  • Erythropoietin / therapeutic use*
  • Female
  • Glomerular Filtration Rate
  • Hematinics / therapeutic use*
  • Hemoglobins / metabolism
  • Humans
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Patient Selection
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Quality of Life*
  • Recombinant Proteins
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Hematinics
  • Hemoglobins
  • Recombinant Proteins
  • Erythropoietin
  • Creatine