Quality of life

Is quality of life a valid treatment target?running

Quality of life (QoL) is impaired in patients with CHF and can be similar to, or lower than, QoL in patients with depression or undergoing dialysis.1 Therefore, QoL may be an important treatment target for patients with CHF.2

  • Despite recent evidence of improved prognosis after first hospitalization for heart failure, pharmacological treatment does not substantially improve high morbidity and mortality rates associated with CHF.3
  • As a result, treatment of CHF focuses mostly on symptomatic improvement and modulating disease progression.3,4

A key objective for nephrologists is effective and sustained correction of anaemia and its underlying causes to improve QoL.5,6

Anaemia and iron deficiency can be associated with impaired QoL in CRAS patients.7

  • Anaemia and iron deficiency cause fatigue and reduced exercise capacity.7
  • In observational studies, anaemia is also associated with hospitalization, faster progression to end-stage renal disease and increased mortality.8

Correction of iron deficiency, with or without anaemia, significantly improves QoL within 4 weeks in patients with CHF.9

References
1. Juenger J et al. Heart 2002;87:235–241
2. Jaarsma T. Heart 2005;91:832–838
3. Dickstein K et al. Eur J Heart Fail 2008;10: 933-89
4. Jaarsma T  etal. European Journal of Heart Failure (2009) 11, 433–443
5. Roberts TL et al. Nephrol Dial Transplant2006;21:1652–1662
6. Spinowitz BS et al. J Am Soc Nephrol 2008;19:1599–1605
7. Haas JD, Brownlie T. J Nutr. 2001;131:676S-688S.
8. Thorp ML et al. Nephrology (Carlton). 2009;14:240-246
9. Anker SD et al. N Engl J Med 2009;361:2436–2448

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