Kidney Week

Abstract: TH-PO266

Associations of Anemia with Quality of Life in CKD Stage 3-5 Patients: Results from CKDopps in the US and Brazil

Session Information

• Anemia and Iron Metabolism: Clinical
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Sukul, Nidhi, University of Michigan, Ann Arbor, Michigan, United States

Nidhi Sukul,

• Muenz, Daniel G., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Daniel G. Muenz,

• Speyer, Elodie, CESP Inserm U1018, VILLEJUIF Cedex, France

Elodie Speyer,

• Lopes, Antonio Alberto, Faculdade de Medicina da Universidade Federal da Bahia, Salvador, BAHIA, Brazil

Antonio Alberto Lopes,

• Asahi, Koichi, Fukushima Medical University School of Medicine, Fukushima, Japan

Koichi Asahi,

• Hoshino, Junichi, Toranomon Hospital, Tokyo, Japan

Junichi Hoshino,

• Dhalwani, Nafeesa N., Evidera, London, United Kingdom

Nafeesa N. Dhalwani,

• van Haalen, Heleen, AstraZeneca, Gothenburg, Sweden

Heleen van Haalen,

• Pecoits-Filho, Roberto, Pontificia Universidade Catolica do Parana, Curitiba, PARANÁ, Brazil

Roberto Pecoits-Filho,

• Bieber, Brian, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Brian Bieber,

• Robinson, Bruce M., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Bruce M. Robinson,

• Pisoni, Ronald L., Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States

Ronald L. Pisoni,

Background

The risk of anemia increases with chronic kidney disease (CKD) progression. Some studies suggest that anemia is associated with poorer quality of life (QOL) among non-dialysis CKD patients. Using the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps), we report the associations of anemia with QOL outcomes among CKD patients in the US and Brazil.

Methods

We analyzed CKDopps data on patient characteristics, laboratory measurements and the Kidney Disease QOL-36 (KDQOL-36) survey collected prospectively for stage 3-5 CKD patients (N=1212) at 22 US and 15 Brazilian nephrologist-run clinics from 2014-2018. Hemoglobin (Hgb) levels, reported closest in time to KDQOL-36 completion (median gap: 13 days, IQR: 1-57 days), were modelled separately as continuous and categorical exposures in GEE linear regression models for each QOL outcome, adjusting for country, age, sex, race, smoking history, eGFR, serum albumin, and 13 comorbidities, and accounting for clustering by clinic.

Results

More severe anemia was most strongly associated with poorer scores for QOL domains of general health, physical role, emotional role, burden, effects of kidney disease, as well as the physical and mental component summary scores. Weak to moderate associations were observed with the domains of energy, physical function, and pain.

Conclusion

These findings show moderate associations between anemia and poorer outcomes on several QOL domains in CKD stage 3-5 patients from the US and Brazil, even after accounting for numerous comorbidities. Longitudinal studies would be valuable to understand how patient QOL and well-being are impacted by anemia and its treatment over time.

Funding

• NIDDK Support – This analysis was supported by AstraZeneca. The DOPPS Program is supported by Amgen, Kyowa Hakko Kirin, Baxter Healthcare. Additional support for specific projects and countries is provided by AstraZeneca, European Renal Association-European Dialysis & Transplant Association (ERA-EDTA), Fresenius Medical Care Asia-Pacific Ltd, Fresenius Medical Care Canada Ltd, German Society of Nephrology (DGfN), Janssen, Japanese Society for Peritoneal Dialysis (JSPD), Keryx, Kidney Care UK, MEDICE Arzneimittel Pütter GmbH & Co KG, Proteon, and Vifor Fresenius Medical Care Renal Pharma. Public funding and support is provided for specific DOPPS projects, ancillary studies, or affiliated research projects by National Health & Medical Research Council (NHMRC) in Australia, Cancer Care Ontario (CCO) through the Ontario Renal Network (ORN) in Canada, French National Institute of Health and Medical Research (INSERM) in France, Thailand Research Foundation (TRF), Chulalongkorn University Matching Fund, King Chulalongkorn Memorial Hospital Matching Fund, and the National Research Council of Thailand (NRCT) in Thailand, National Institute for Health Research (NIHR) via the Comprehensive Clinical Research Network (CCRN) in the United Kingdom, and National Institutes of Health (NIH) in the US. All support is provided without restrictions on publications. All grants are made to Arbor Research Collaborative for Health and not to Dr. Muenz directly.