#3499 The influence of anemia on quality of life of patients on hemodialysis and peritoneal dialysis

Abstract Background and Aims Quality of life (QoL) is a broad concept that includes an assessment of personal well-being formed by various criteria of physical, psychological, emotional and social nature. Chronic kidney disease (CKD) often leads to anemia, due to lack of erythropoietin production. Combination of CKD, renal anemia and dialysis treatment significantly worsens the QoL of patients. The Kidney Disease and Quality of Life SF-36 v 1.3 (KDQOL-SF-36™) is specialized questionnaire for measuring QoL in patients with CKD, using 8 domains like the classic SF-36 and one section with 12 domains measuring the QoL of patients on CKD with or without dialysis treatment. The aim of this study is to evaluate QoL related to CKD and also to establish the renal anemia effect on QoL in CKD patients on dialysis, using the disease specific items of the KDQOL-SF-36. Method The study includes 79 patients with CKD and anemia on hemodialysis (HD) and peritoneal dialysis (PD) treatment. Demographic data, comorbidities, haematological parameters, vascular access, duration of dialysis were recorded. Every patient completed the questionnaire after given informed consent. Results There were 40 (50.6%) men and 39 (49.4%) women, with average age of 57.9 ± 14.2 years and duration of HD of 79.9 ± 79.4 months and of CAPD—48.0 ± 47.1 months. Haemodialysis are 67, PD—12 patients. The leading causes for CKD are chronic glomerulonephritis (32.9 %), hypertensive nephropathy (29.1%), autosomal dominant polycyclic kidney disease (11.4%). Patients on HD have haemoglobin—104.8±14.1 g/l, and weekly dosage of erythropoietin 5196.9 ± 2962.43 E. These on PD have better correction of renal anemia, haemoglobin— 112.8 ± 15.2 g/l with lower need of erythropoietin – 4111.1 ± 2800.2 E/weekly. The group of PD patients have a better score in six domains—physical functioning (FF), role physical (RL), body pain (BP), role emotional (RLE), social function (SF), energy fatigue (VEF), and better in kidney disease specific domains—effects of kidney disease(EFKD), burden of KD (BKD), sleep. A tendency was registered among the HD group about one domain—General Health perception (GHP)—patients with longer stage of HD treatment—between 3 and 30 years have higher score, than the patients who started HD sooner—in less than 3 years. Conclusion Patients with CKD and anemia have changed due to insufficiency of energy levels, fatigue, insomnia, poоr tissues oxidation, etc. Due to multifactorial reasons, the patients on dialysis treatment with anaemia have even lower score of QoL. Patients on PD not only have a more flexibility than HD ones, but also they have better QoL. We prove, that patients adapted to the treatment's regimen and specificity, have better perception of life, than the newly started ones. KDQOL-SF-36™ is a sure and organ specific instrument for measuring QoL in the population of dialysis patients. This is the first study in Bulgaria evaluating and comparing QoL in patients treated with both dialysis methods—HD and PD.