Relation between level or change of hemoglobin and generic and disease-specific quality of life measures in hemodialysis

Objective: We sought to examine the relation between meeting or exceeding the current minimum guideline for hemoglobin (11 g/dl) in dialysis patients and generic and disease-specific QOL scores at 1 year. Methods: In 438 incident hemodialysis patients from a national prospective cohort study, we used regression models to predict QOL score (all scaled 0-100) at 1 year using 6-month values of hemoglobin, adjusting for potential confounders. Results: Compared to values <11 g/dl, hemoglobin ≥11 g/dl at 6 months was associated with higher scores for the general domains of physical functioning, role physical, mental health, social functioning, and bodily pain at 1 year; cognitive function, diet restriction, and dialysis access dialysis-specific domain scores were also higher for these patients. Each 1 g/dl greater hemoglobin was also statistically significantly associated with higher QOL scores for most domains. In longitudinal analyses, most of the domains showed that, with each 1 g/dl increase in hemoglobin concentration from baseline to 6 months, QOL score increased significantly over the first year. Conclusions: Hemodialysis patients who attain higher hemoglobin concentration at 6 months, especially ≥11 g/dl, have better QOL at 1 year, with regard to important physical, mental, social, and cognitive domains.