Cardiac biomarkers and health-related quality of life in new hemodialysis patients without symptomatic cardiac disease

Williams, Christopher E. (2015) Cardiac biomarkers and health-related quality of life in new hemodialysis patients without symptomatic cardiac disease. Masters thesis, Memorial University of Newfoundland.

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Abstract

Background & Objectives: Quality of life (QOL) is impaired in end-stage renal disease patients, but the cause(s) is uncertain. To determine whether biomarkers of cardiac disease (TNT, NT-proBNP) were associated with change in QOL in the short (24 weeks) and long term (48 & 96 weeks) we studied 596 new hemodialysis patients without symptomatic cardiac disease followed for 2 years. Design, Setting, Participants & Measurements: Patients were enrolled in a doubleblind, randomized controlled trial to assess the impact of anemia correction with erythropoietin. Change in QOL was measured using SF-36, FACIT Fatigue administered at 0, 24, 48 and 96 weeks, with pre-specified domains of interest being SF-36 Physical Functioning, SF-36 Vitality and FACIT Fatigue. In addition to baseline demographic and clinical characteristics, baseline biomarkers of cardiac disease and inflammation were assessed. Results: The analysis plan pre-specified cut-off for baseline biomarkers as upper quartile. High Trop levels were independently and significantly associated with long term deterioration in all 3 domains. The adjusted B for change in physical function was -6.7 (p=0. 035) at 48 weeks and -7.1(p=0.056) at 96 weeks; for change in vitality - 7.1(p=0.036) at 96 weeks; and for change in fatigue-6.2(p=0.035). Conclusions: In relatively healthy hemodialysis patients, high troponin T levels were associated with deterioration in physical function and vitality as well as increasing fatigue.

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