Controlled study on the improvement of quality of life in elderly hemodialysis patients after correcting end-stage renal disease-related anemia with erythropoietin

Moreno, F; Aracil, Francisco J.; Pérez, Rafael; Valderrábano, Fernando

doi:10.1016/s0272-6386(96)90166-3

Cited by 106 publications

(60 citation statements)

References 13 publications

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“…18,23,24 However, several previous studies conducted with HD patients have indicated a relationship between a low level of Hgb and fatigue. 25,26,27,28,29 In our patients, there was relationship between Hgb levels and fatigue. Our fi ndings suggest that identifying the existence of anemia routinely and providing adequate treatment for anemia might be an effective strategy for decreasing levels of fatigue.…”

Section: Discussionmentioning

confidence: 49%

Fatigue in People Undergoing Hemodialysis

Mollaoğlu

2009

Dialysis & Transplantation

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AIM: Levels of fatigue as experienced by people undergoing hemodialysis (HD) were assessed using the Visual Analog Scale for Fatigue (VAS-F).METHOD: The VAS-F was completed by 138 people with ESRD who were patients of HD units in Sivas, Turkey. Demographic and renal health history data were also collected with a structured questionnaire. The statistical analyses used in order to evaluate the data include: student's t-test, Kruskal-Wallis test, Pearson correlation test, and logistic regression analysis.RESULTS: The level of fatigue experienced by people with HD in our study was high, and their energy level was low. Univariate analysis showed that levels of fatigue differed by gender, age, education, employment, and presence of anemia. However, logistic regression analysis, age, and duration of dialysis were found to be the independent predictors of fatigue. CONCLUSIONS:The results of the study indicated that high levels of fatigue are experienced. In order to improve patient care and promote patient's quality of life, nephrology professionals should understand the comprehensive assessment of fatigue and work with patients to initiate a range of strategies and interventions to address it.

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Section: Discussionmentioning

confidence: 49%

Fatigue in People Undergoing Hemodialysis

Mollaoğlu

2009

Dialysis & Transplantation

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“…Adapted from Regidor et al 13 In addition to associations of blood hemoglobin with mortality and hospitalizations in the CKD population, anemia is associated with fatigue, weakness, shortness of breath, and a decreased health-related quality of life. 33,34 Furthermore, hemoglobin overshoot may be associated with various safety concerns, including the development of elevated BP with risk for hypertensive encephalopathy, 35 iron deficiency, 36 high platelet count, [37][38][39] thrombotic events, 40 and accelerated left ventricular dysfunction and hypertrophy. 7 …”

Section: Consequences Of Hemoglobin Variabilitymentioning

confidence: 99%

Hemoglobin Variability in Anemia of Chronic Kidney Disease

Kalantar-Zadeh

Aronoff

2009

Journal of the American Society of Nephrology

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“…Consequently, management of anemia by recombinant human erythropoietin (EPO) by increasing serum hemoglobin toward the target of 11.0 to 12.0 g/dl is reported consistently to improve outcome measures in MHD patients (3)(4)(5)(6). However, much controversy exists with regard to the association between measures of iron stores or changes in these values by iron administration and clinical outcome in these individuals (7).…”

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confidence: 99%

Time-Dependent Associations between Iron and Mortality in Hemodialysis Patients

Kalantar-Zadeh¹,

Regidor²,

McAllister³

et al. 2005

Journal of the American Society of Nephrology

265

261

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The independent association between the indices of iron stores or administered intravenous iron, both of which vary over time, and survival in patients who are on maintenance hemodialysis (MHD) is not clear. It was hypothesized that the observed associations between moderately high levels of three iron markers (serum ferritin, iron, and iron saturation ratio) or administered intravenous iron and all-cause and cardiovascular death is due to the time-varying confounding effect of malnutrition-inflammation-cachexia syndrome (MICS). Time-dependent Cox regression models were examined using prospectively collected data of the 2-yr (July 2001 to June 2003) historical cohort of 58,058 MHD patients from virtually all DaVita dialysis clinics in the United States. After time-dependent and multivariate adjustment for case mix, administered intravenous iron and erythropoietin doses, and available surrogates of MICS, serum ferritin levels between 200 and 1200 ng/ml (reference 100 to 199 ng/ml), serum iron levels between 60 and 120 g/ml (reference 50 to 59 g/ml), and iron saturation ratio between 30 and 50% (reference 45 to 50%) were associated with the lowest all-cause and cardiovascular death risks. Compared with those who did not receive intravenous iron, administered intravenous iron up to 400 mg/mo was associated with improved survival, whereas doses >400 mg/mo tended to be associated with higher death rates. The association between serum ferritin levels >800 ng/ml and mortality in MHD patients seems to be due mostly to the confounding effects of MICS. I n patients who are on maintenance hemodialysis (MHD), markers of anemia, including low blood hemoglobin concentrations, are associated with poor clinical outcomes (1,2). Consequently, management of anemia by recombinant human erythropoietin (EPO) by increasing serum hemoglobin toward the target of 11.0 to 12.0 g/dl is reported consistently to improve outcome measures in MHD patients (3-6). However, much controversy exists with regard to the association between measures of iron stores or changes in these values by iron administration and clinical outcome in these individuals (7). Although in the pre-EPO era iron overload was a major cause of morbidity in MHD patients, its significance in the post-EPO era remains unclear. A recent observational study in 1283 MHD patients indicated that a low, rather than a high, baseline serum iron quartile was associated with increased mortality and hospitalization over 12 mo of observation (8). Even though quartile analysis enables us to uncover nonlinear relationships, large sample sizes with repeated measures are needed to compare the mortality predictability of smaller increments of iron markers. Moreover, the association between other iron markers and survival remains to be determined.Many observational studies have examined the association between a baseline laboratory value at the start of the cohort and the survival and ignored variations in clinical and laboratory measures over time. It is not clear whether longitudinal changes in...

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Controlled study on the improvement of quality of life in elderly hemodialysis patients after correcting end-stage renal disease-related anemia with erythropoietin

Cited by 106 publications

References 13 publications

Fatigue in People Undergoing Hemodialysis

Fatigue in People Undergoing Hemodialysis

Hemoglobin Variability in Anemia of Chronic Kidney Disease

Time-Dependent Associations between Iron and Mortality in Hemodialysis Patients

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