Real-World Impact of Cardiovascular Disease and Anemia on Quality of Life and Productivity in Patients with Non-Dialysis-Dependent Chronic Kidney Disease

Abstract

IntroductionPatients with chronic kidney disease (CKD) have an increased risk of comorbid conditions, including cardiovascular disease (CVD). Anemia is prevalent in the CKD population and worsens as kidney function declines, resulting in a diminished quality of life and increased morbidity/mortality. The purpose of this secondary analysis was to determine the real-world prevalence of CVD among patients with non-dialysis-dependent CKD (NDD-CKD), with and without comorbid anemia, and to assess the impact of these conditions on quality of life (QoL) and work productivity.MethodsData were drawn from the Adelphi CKD Disease-Specific Programme, conducted in France, Germany, Italy, Spain, and the UK (2012). Anonymized data were collected via patient record forms and patient-completed questionnaires. Patient data were stratified by anemic status and the presence of CVD comorbidity.ResultsData were collected by physicians for 1993 patients, of whom 867 completed a patient-completed questionnaire. A total of 61.4% of patients had anemia, and the prevalence of anemia increased with CKD stage. Patients with anemia had a higher mean number of cardiovascular comorbidities than non-anemic patients (1.27 vs 0.95, respectively; P < 0.001). The presence of cardiovascular conditions was associated with a significantly reduced QoL (EuroQol EQ-5D-3L visual analog scale: coefficient, −5.68 in anemic patients; P = 0.028) and work productivity and activity impairment (WPAI activity impairment: coefficient, +8.04 in anemic patients; P = 0.032), particularly among anemic patients.ConclusionsThe presence of anemia in this cohort of NDD-CKD patients was high. The presence of concomitant cardiovascular conditions was more common in NDD-CKD patients with comorbid anemia, and was associated with reduced QoL and work productivity outcomes.Electronic supplementary materialThe online version of this article (doi:10.1007/s12325-017-0566-z) contains supplementary material, which is available to authorized users.

Evaluation of the effect of lanthanum carbonate hydrate on the pharmacokinetics of roxadustat in non‐elderly healthy adult male subjects

“…In patients with chronic kidney disease (CKD), malfunction of the kidneys results in an insufficient rate of erythropoiesis due to decreased levels of EPO production . Renal anaemia in patients with CKD becomes more prevalent as CKD progresses and is often associated with a reduced quality of life and work productivity, as well as an elevated risk for cardiovascular disease …”

“…1 Renal anaemia in patients with CKD becomes more prevalent as CKD progresses and is often associated with a reduced quality of life and work productivity, as well as an elevated risk for cardiovascular disease. 2 Roxadustat (ASP1517, FG-4592, AZD9941) is an orally bioavailable hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) in development for the treatment of anaemia in CKD. Roxadustat stimulates erythropoiesis by targeting hypoxia-inducible factors, a family of transcription factors that up-regulate EPO production in response to hypoxia.…”

A nurse prescriber‐led protocol for anaemia management in established haemodialysis patients: A retrospective study

“…Nurse prescribing is a relatively new concept in dialysis settings, which encompasses a patient population that is complex, with multiple co‐morbidities and where current trends place greater emphasis on the decision‐making role of nurses particularly in the area of renal anaemia management. Anaemia, a common complication of chronic and end‐stage kidney disease, contributes to higher patient morbidity, mortality and poorer health‐related quality of life and poses significant challenges for the management of haemodialysis patients (Bonner, Caltabiano, & Berlund, 2013; Covic, Jackson, Hadfield, Pike, & Siriopol, 2017; Eriksson, Goldsmith, Teitsson, Jackson, & Nooten, 2016; He et al., 2017; Sato et al., 2018). The use of erythropoietin‐stimulating agent and iron therapy revolutionised anaemia control by reducing the possibility of blood transfusions in haemodialysis patients (Gardiner et al., 2019).…”

Apo A1 / Apo B Ratio and Acute Coronary Syndrome Among Peritoneal Dialysis Patients

“…A reduction in the estimated glomerular ltration rate is a major independent predictor of cardiovascular morbidity and mortality and all-cause mortality [2]. Many risk factors increase the CVD burden in CKD patients, including oxidative stress [3], chronic in ammation [4], endothelial dysfunction [5], renal anemia [6], lipid metabolism disorders [7], secondary hyperparathyroidism, and mineral metabolism disorders [8]. Dyslipidemia may directly affect the kidney by causing deleterious renal lipid derangement [9].…”