HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Press Release All Versions of this Article: CJN.04950908v1 4/4/726    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Foley, R. N. Articles by Parfrey, P. S. Search for Related Content PubMed PubMed Citation Articles by Foley, R. N. Articles by Parfrey, P. S.

Erythropoietin Therapy, Hemoglobin Targets, and Quality of Life in Healthy Hemodialysis Patients: A Randomized Trial

Robert N. Foley^*, Bryan M. Curtis, and Patrick S. Parfrey

^* Chronic Disease Research Group and University of Minnesota, Minneapolis, Minnesota; Memorial University of Newfoundland, St. John's, Newfoundland, Canada

Correspondence: Patrick Parfrey, Health Sciences Centre, Memorial University of Newfoundland, Street John's, NL, Canada A1B 3V6, Phone: 709-777-7261; Fax: 709-777-6995; E-mail: pparfrey{at}mun.ca

Background and objectives: The effects of different hemoglobin targets when using erythropoiesis-stimulating agents on quality of life are somewhat controversial, and predictors of change in quality of life in endstage renal disease have not been well characterized.

Design, setting, participants, & measurements: Five hundred ninety-six incident hemodialysis patients without symptomatic cardiac disease were randomly assigned to hemoglobin targets of 9.5 to 11.5 g/dl or 13.5 to 14.5 g/dl for 96 weeks, using epoetin_alfa as primary therapy. Patients and attending physicians were masked to treatment assignment. Quality of life, a secondary outcome, was prospectively recorded using the Kidney Disease Quality of Life (KDQoL) questionnaire at weeks 0, 24, 36, 48, 60, 72, 84, and 96, with prespecified outcomes being fatigue and quality of social interaction.

Results: The mean age and prior duration of dialysis therapy of the study population were 50.8 and 0.8 yr. Mortality was low, reflecting the relatively healthy group enrolled. Of 20 domains within the KDQoL only the prespecified domain of fatigue showed significant change over time between the two groups. Improvement in fatigue scores in the high-target group ranged from 3.2 to 7.9 over time (P = 0.007) compared with change in the low-target group. Higher body mass index and lower erythropoietin dose at baseline were independent predictors of improvement in multiple KDQoL domains.

Conclusions: In relatively healthy hemodialysis patients, normal hemoglobin targets may have beneficial effects on fatigue. Improvement in multiple domains of quality of life is associated with higher body mass index and lower erythropoietin requirements.

This article has been cited by other articles:

				P. A. Marsden Treatment of Anemia in Chronic Kidney Disease -- Strategies Based on Evidence N. Engl. J. Med., November 19, 2009; 361(21): 2089 - 2090. [Full Text] [PDF]