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Review
. 2024 Jul 4;17(8):sfae205.
doi: 10.1093/ckj/sfae205. eCollection 2024 Aug.

Anaemia and quality of life in chronic kidney disease: a consensus document from the European Anaemia of CKD Alliance

Indranil Dasgupta  1   2 , Corinne Isnard Bagnis  3 , Matteo Floris  4 , Hans Furuland  5 , Daniel Gallego Zurro  6 , Loreto Gesualdo  7 , Nathalie Heirman  8 , Roberto Minutolo  9 , Antonello Pani  4   10 , José Portolés  11   12 , Christian Rosenberger  13 , José Emilio Sánchez Alvarez  14 , Pablo Ureña Torres  15   16 , Raymond C Vanholder  17   18 , Christoph Wanner  19 ; European Anaemia of aCKD Alliance
Collaborators, Affiliations
Review

Anaemia and quality of life in chronic kidney disease: a consensus document from the European Anaemia of CKD Alliance

Indranil Dasgupta et al. Clin Kidney J. .

Abstract

Anaemia is common in chronic kidney disease (CKD) and has a significant impact on quality of life (QoL), work productivity and outcomes. Current management includes oral or intravenous iron and erythropoiesis-stimulating agents (ESAs), to which hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) have been recently added, increasing the available therapeutic options. In randomised controlled trials, only intravenous iron improved cardiovascular outcome, while some ESAs were associated with increased adverse cardiovascular events. Despite therapeutic advances, several challenges and unmet needs remain in the current management of anaemia of CKD. In particular, clinical practice does not include an assessment of QoL, which prompted a group of European nephrologists and representatives of patient advocacy groups to revisit the current approach. In this consensus document, the authors propose a move towards a more holistic, personalised and long-term approach, based on existing evidence. The focus of treatment should be on improving QoL without increasing the risk of adverse cardiovascular events, and tailoring management strategies to the needs of the individual. In addition, the authors discuss the suitability of a currently available anaemia of CKD-specific health-related QoL measure for inclusion in the routine clinical management of anaemia of CKD. The authors also outline the logistics and challenges of incorporating such a measure into electronic health records and how it may be used to improve QoL for people with anaemia of CKD.

Keywords: CKD; anaemia; dialysis; guidelines; quality of life.

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Conflict of interest statement

I.D. has received research grants from Baxter, Medtronic and Sanofi and honoraria for advisory boards and speaker meetings from AstraZeneca, Bayer, GSK, Sanofi and Vifor Pharma. M.F. has received consultancy fees from AstraZeneca and GSK. H.F. has received consultancy and speaker fees from AstraZeneca, BMS, Sanofi, GSK and Vifor Pharma. L.G.’s university department (DIMEPRE-J) received research grants from Abionyx and Sanofi; he has received consultancy and speaker fees from AstraZeneca, Baxter, Chinook, GSK, Medtronic, Mundipharma, Novartis, Pharmadoc, F. Hoffmann-La Roche Ltd, Sandoz, Sanofi, Travere, Vifor Pharma, Astellas Pharma, Estor, Fresenius Kabi and Werfen. N.H. is an employee of GSK. R.M. has been a member of advisory boards for Amgen, Astellas Pharma and GSK; has received consultancy fees from Bayer and GSK and has been an invited speaker at meetings supported by Amgen, Astellas Pharma, AstraZeneca and Vifor Pharma. A.P. has received consultancy fees from AstraZeneca and GSK. J.P. has received consultancy and speaker fees from Astellas Pharma, GSK and Vifor Pharma. C.R. has received consultancy and speaker fees from Akebia, Astellas Pharma, AstraZeneca, Boehringer Ingelheim, GSK, Otsuka and Vifor Pharma. J.E.S.A. has received consultancy and speaker fees from Astellas Pharma, Baxter, GSK and Vifor Pharma. P.U.T. has received honoraria for advisory boards and speaker meetings from Amgen, Astellas Pharma, AstraZeneca, Baxter, GSK, Théradial and Vifor Pharma. R.C.V. is an advisor to AstraZeneca, Baxter, Fresenius Kabi, Fresenius Medical Care, GSK, Kibow Biotech, Nextkidney, Nipro and Novartis. C.W. has received consultancy fees from Amgen, Amicus, Astellas Pharma, AstraZeneca, Bayer, Boehringer Ingelheim, Vifor Pharma, Chiesi, Chugai, Fresenius Medical Care, GSK, Idorsia, Eli Lilly, MSD, Novartis and Novo Nordisk and grants and consultancy fees from Boehringer Ingelheim and Sanofi. C.I.B. and D.G.Z. have nothing to declare.

Figures

Figure 1:
Figure 1:
Summary of QoL issues for people with anaemia of CKD. The current management of people with anaemia of CKD and its impact on QoL is illustrated in the upper panels in terms of (A) unmet needs in the management of anaemia of CKD, (B) opposing individual profiles and (C) current tools used for HRQoL measurements in anaemia of CKD. The ideal management of people with anaemia of CKD is illustrated in the lower panel with a focus on (D) the ideal tool for monitoring HRQoL measurements in anaemia of CKD, (E) personalised anaemia of CKD educational programs and (F) personalised management of anaemia of CKD. CV: cardiovascular.
Figure 2:
Figure 2:
HRQoL survey management. Proposed pathway for comprehensive HRQoL management in the hospital and out of hospital.
See this image and copyright information in PMC

References

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