Effect of higher hemoglobin levels on health-related quality of life parameters

Abstract

A large body of clinical data has consistently demonstrated that improvements in health-related quality of life (QOL) are associated with hemoglobin (Hb) and hematocrit (Hct) levels maintained in the range recommended by the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (NKF-K/DOQI). Hb (Hct) levels between 11 and 12 g/dL (33% to 36%) yield significant improvements in QOL parameters such as cognitive function, exercise and functional ability, and overall health status. Additional data showing a strong association between improvements in QOL, hospitalization, and mortality in those with higher Hb levels underscore why all patients should attain a minimum Hb level of 11 g/dL. Recent clinical analyses indicate that increasing Hb to above 12 g/dL may be associated with incremental improvements in QOL. However, further clinical research is required to define and clarify these relationships. While higher Hb levels may be justifiable in some patients with debilitating comorbid conditions and documented clinical necessity, the NKF-K/DOQI target range currently remains the standard of care.