Association of anemia and mineral and bone disorder with health-related quality of life in Asian pre-dialysis patients

Health and Quality of Life Outcomes

Research

Pallavi Tyagi¹  Anantharaman Vathsala¹  Benjamin Jun Jie Seng²  Jia Jia Lee²  Kok Joon Chong²  Priscilla How³  Hwee-Lin Wee⁴ 

[1] Department of Medicine (Division of Nephrology), National University Hospital, Singapore, Singapore;Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, 18 Science Drive 4, 117543, Singapore, Singapore;Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, 18 Science Drive 4, 117543, Singapore, Singapore;Department of Medicine (Division of Nephrology), National University Hospital, Singapore, Singapore;Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, 18 Science Drive 4, 117543, Singapore, Singapore;Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore;

关键词: Pre-dialysis;    Anemia;    Mineral and bone disorder;    Health-related quality of life;    Pill burden;   

DOI  :  10.1186/s12955-016-0477-8

 received in 2015-10-26, accepted in 2016-04-30,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPatients with chronic kidney disease (CKD) have poor health-related quality of life (HRQoL). The association of CKD-related complications such as anemia and mineral and bone disorders (MBD) with HRQoL in pre-dialysis patients is not well-studied. As such, this study aimed to determine the association of anemia and MBD with HRQoL in pre-dialysis patients.MethodsThis was a cross-sectional study involving 311 adult pre-dialysis patients with stage 3–5 CKD from an acute-care hospital in Singapore. Patients’ HRQoL were assessed using Kidney Disease Quality of Life Short Form (KDQOL-SF™) and EuroQol 5 Dimensions–3 levels (EQ5D-3L). HRQoL between patients with and without anemia or MBD were compared by separate hierarchical multiple linear regression analyses using various HRQoL scales as dependent variables, adjusted for sociodemographic, clinical and psychosocial variables.ResultsAfter adjusting for MBD, anemia was associated with lower HRQoL scores on work status (WS), physical functioning (PF) and role physical [β (SE): −10.9 (4.18), p = 0.010; −3.0 (1.28), p = 0.018; and −4.2 (1.40), p = 0.003, respectively]. However, significance was lost after adjustments for sociodemographic variables. Patients with MBD had poorer HRQoL with respect to burden of kidney disease, WS, PF and general health [(β (SE): −7.9 (3.88), p = 0.042; −9.5 (3.99), p = 0.018; −3.0 (1.22) p = 0.014; −3.6 (1.48), p = 0.015, respectively]. Although these remained significant after adjusting for sociodemographic variables, significance was lost after adjusting for clinical variables, particularly pill burden. This is of clinical importance due to the high pill burden of CKD patients, especially from medications for the management of multiple comorbidities such as cardiovascular and mineral and bone diseases.ConclusionsNeither anemia nor MBD was associated with HRQoL in our pre-dialysis patients. Instead, higher total daily pill burden was associated with worse HRQoL. Medication reconciliation should therefore be routinely performed by clinicians and pharmacists to reduce total daily pill burden where possible.

【 授权许可】

CC BY   
© The Author(s). 2016