Saudi Journal of Kidney Diseases and Transplantation

: 2016  |  Volume : 27  |  Issue : 5  |  Page : 1063--1067

Relationship between anemia, quality of life, and laboratory indices in hemodialysis patients

Mahdi Sadeghi1, Hossein Ebrahimi2, Mohammad Abbasi3, Reza Norouzadeh4,  
1 Department of Nursing, Disaster and Emergency Medical Management Center, Shahroud University of Medical Sciences, Shahroud, Iran
2 Department of Nursing, Randomized Controlled Trial Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
3 Department of Nursing, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran
4 Department of Nursing, School of Nursing and Midwifery, Shahed University, Tehran, Iran

Correspondence Address:
Dr. Hossein Ebrahimi
Department of Nursing, Randomized Controlled Trial Research Center, Shahroud University of Medical Sciences, Shahroud

How to cite this article:
Sadeghi M, Ebrahimi H, Abbasi M, Norouzadeh R. Relationship between anemia, quality of life, and laboratory indices in hemodialysis patients.Saudi J Kidney Dis Transpl 2016;27:1063-1067

How to cite this URL:
Sadeghi M, Ebrahimi H, Abbasi M, Norouzadeh R. Relationship between anemia, quality of life, and laboratory indices in hemodialysis patients. Saudi J Kidney Dis Transpl [serial online] 2016 [cited 2020 Sep 24 ];27:1063-1067
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Full Text

To the Editor,

Chronic renal failure (CRF) is on the rise in developing countries. [1],[2] The prevalence of CRF has increased from 234 cases/million population in 2000 [3] to 357 in 2006. [4] About one million patients survive through dialysis in the world. [5] Hemodialysis (HD) is the most common method of treatment in many countries and also in Iran. [6] The growth of endstage renal disease in Iran has been reported as 12% per year. [7] HD patients have a lower quality of life (QOL) and survival and major lifestyle changes occur in these patients. [8],[9] HD affects health status and personal roles [10] leading to significantly reduced QOL compared with the general population. [11],[12]

Anemia in chronic kidney disease is a common problem that usually results from inadequate erythropoietin production. [13] According to studies, the outcome of correcting anemia in dialysis patients has been associated with general health improvement [14],[15],[16],[17],[18] as well as reducing the mortality rate in these patients. [19],[20] The lower than normal levels of hemoglobin (Hb) have a negative effect on QOL of these patients. [21],[22] DeVita et al showed that lower or higher than recommended levels of Hb in HD patients is associated with complications such as cardiovascular disorders, dysrhythmias and cardiac hypertrophy, stroke, and arteriovenous fistula dysfunction. [23] Anemia increases the risk of hospitalization, morbidity, and mortality in hemodialysis patients. [24],[25]

This study aims to determine the relationship between anemia, QOL, and some laboratory indices in HD patient.

In this cross-sectional study, HD patients older than 18 years in Imam Hossein (AS), Shroud, in 2014 were studied. This hospital is a referral center for dialysis patients. All participants of the study were informed about the purpose of the study and signed an informed consent form. Approval of the University Ethics Committee was obtained (code: 920/02).

Data collected included demographic information and QOL questionnaire for patients on dialysis (kidney disease quality of life). This questionnaire is a valid and reliable [26] and has a high degree of internal consistency and correlation [27] and offers a deep and broad interpretation of the variables related to the QOL in HD patients. [28] Yekaninejad et al confirm the good reliability and validity of the questionnaire in the Iranian population. [29] Higher scores indicate higher QOL. We also extracted from medical records: the serum values of albumin, bilirubin, potassium, calcium, phosphorus, fasting blood glucose, creatinine, and sodium. The tests were performed in the laboratory of Imam Hossein Hospital. After collecting the data, the correlation between variables and QOL was analyzed using the Pearson correlation coefficient.

Ninety-nine patients were enrolled in this study. The mean age was 5.98 ± 10.98 year; 61.6% were male. Sixty-three patients had been on dialysis for more than two years. Seventy of the patients receive three or more dialysis session a week [Table 1]. The result showed that the mean Hb was 10.36 ± 0.95 (g/dL) and hematocrit (HCT) was 32.60 ± 3.25 (%). Pearson correlation coefficients showed a significant positive correlation between Hb and HCT with the QOL, i.e., the patients with higher levels of index had a higher QOL [Table 2].{Table 1}{Table 2}

Furthermore, the Pearson correlation coefficient showed there was a correlation between Hb and HCT with albumin, bilirubin, potassium, calcium, and phosphorus. While did not show significant with glucose, creatinine, and sodium [Table 3].{Table 3}

In this study, the mean of Hb was 10.36 ± 0.95 and HCT was 32.60 ± 3.25 which is similar to that reported by Hanafusa. [25] Recommended values for Hb in HD patient for men is >13.5 g/dL and for women is >12 g/dL. [30]

We found a positive correlation between Hb and the QOL score. Following the use of erythropoietin and increasing the Hb, the QOL in HD patients improved considerably [31] including higher levels of physical, cognitive, and psychological QOL. [20],[32],[33],[34],[35],[36],[37],[38],[39]

We also found a significant correlation between Hb and HCT with the following laboratory indices: albumin, bilirubin, potassium, calcium, and phosphorus but not with blood glucose, creatinine, and sodium. The results of several studies have shown improvements in physical, sexual, cognitive functions as well as correction of metabolic disorders. [40],[41] In this regard, the nurses can help to health promotion with patient and family education about dietary requirement to increase the Hb and Hb level. [42]

Based on the findings, it is concluded the higher Hb associated with more favorable of QOL and laboratory indices.

The limitations of this study include the small number of the sample studied and the crosssectional nature of the study.

Conflict of interest: None declared.


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