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Kidney Week

Abstract: TH-PO960

Physical Quality of Life, Anemia, and Iron Stores Among Incident Peritoneal Dialysis Patients: Preliminary Findings from a Multinational Observational Study

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Pecoits, Peter G., Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Rigodon, Vladimir, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Jiao, Yue, Fresenius Medical Care, Waltham, Massachusetts, United States
  • Larkin, John W., Fresenius Medical Care, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care AG & Co KGaA, Bad Homburg, Hessen, Germany
  • Kotanko, Peter, Renal Research Institute, New York, New York, United States
  • Pecoits-Filho, Roberto, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Moraes, Thyago Proença de, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
  • Guedes, Murilo Henrique, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil
Background

Adequate hemoglobin (Hb) and iron reserves are vital for tissue/organ functions, and impaired oxygen delivery and iron availability can lead to fatigue and reduced exercise tolerance, ultimately impacting a patient's quality of life (QoL). We aimed to describe biomarkers of anemia and iron stores across different thresholds of KDQOL Physical Component Summary (PCS) scores in patients starting peritoneal dialysis (PD).

Methods

We used data on incident PD patients from a cohort in Brazil (BR) and the United States (US) during Dec 2004-Jan 2011. Patient, lab, and medication data was compared by PCS categories representing an individual's physical well-being/functioning. PCS scores were categorized as ≤35 (low PCS), >35 to ≤40 (moderate-low PCS), >40 to ≤50 (moderate-high PCS), >50 (high PCS).

Results

Demographics for patients who started PD (BR=2,022; US=1,657) were consistent between countries for mean age (BR=57.3 & US=55.6 years) and albumin (both 3.7 g/dL), yet there were more males (BR=45% vs US=54%) and patients of a white race (BR=62% vs US=72%) in the US. Mean PCS scores were slightly higher in BR (41.2) vs the US (38.4). Patients in BR had higher TSAT values (43%) vs the US (30.5%). Erythropoietic stimulating agents (ESA) use was higher in the US (90%) than in BR (35%), as was IV iron use (BR=35% vs. US=42%). Across both cohorts, patients with lower PCS tended to be older, with lower albumin and higher ferritin. While use of ESA tended to be a little higher among patients with lower PCS, Hb and TSAT were similarly distributed across groups in both cohorts (Figure 1).

Conclusion

Physical QOL among patients starting PD in BR and the US appeared to be related to age, nutrition, and ferritin levels. Patients with low PCS scores had relatively preserved iron stores compared to those with better PCS. Results may suggest inflammation could be a driver of lower quality of life in patients with adequate TSAT and Hgb levels.

Funding

  • Commercial Support – Pontificia Universidade Catolica do Parana, Fresenius Medical Care, BaxterHealthcare