Application of the quality of life assessment in nephrology: the quality of life for patients with stage 5 of chronic kidney disease on hemodialysis and the results of clinical and economic analysis of anemia therapy with erythropoetins among these patients

¹Â MOSCOW CITY NEPHROLOGY CENTER, MOSCOW CITY CLINICAL HOSPITAL 52, MOSCOW

²Â I. M. SECHENOV FIRST MOSCOW STATE MEDICAL UNIVERSITY (SECHENOV UNIVERSITY), MOSCOW

³Â MOSCOW CITY RESEARCH INSTITUTE FOR HEALTHCARE AND MEDICAL MANAGEMENT, MOSCOW

Health-related quality of life (HRQOL) in patients with CKD is worse than in the general population, especially in patients receiving hemodialysis. Medical and social characteristics and HRQOL of 723 patients with 5 stage CKD receiving hemodialysis in dialysis centers in Moscow were studied. HRQOL was assessed using the KDQOL-SFTM questionnaire. It was revealed that the lowest scores had the scales «Burden of kidney disease», «Work status», «Role-physical», «Role-emotional» and «General Health perceptions». The scores of the «Physical component summary» and «Mental component summary» were (M±SD) 39,8±9,1 and 43,7±10,9, respectively. Medical and social factors that have a positive and negative impact on the HRQOL of patients have been identified. Evaluation of drug therapy of anemia is given. The clinical and economic analysis of the «cost-effectiveness» of drug therapy of anemia by modern erythropoiesis-stimulating agents (ESAs) — erythropoietins (EPO) of short, medium and long–acting, taking into account the HRQOL of patients, was carried out. It was revealed that long-acting EPO — Methoxypolyethylene glycol-epoetin beta/CERA, is the most effective and least expensive compared to short-acting (Epoetin alpha/Eralphone) and medium-acting drugs (Darbepoetin alpha/Aranesp). It also improves the HRQOL, physical and psychological health («General Health perceptions», «Energy/fatigue» and «Mental component summary»). Thus, the assessment of patients' HRQOL in nephrology is of great theoretical and practical importance, as it allows analyzing the patient’s problems and expanding the amount of information about his health status, the effectiveness of treatment, including informed decision regarding drug therapy, taking into account the patient's opinion. Comparative studies on the assessment of HRQOL and factors affecting it among patients on hemodialysis, peritoneal dialysis and patients with kidney transplant are promising. It is also relevant to create an information system for collecting data on HRQOL for all patients included in the register of patients with CKD on renal replacement therapy.