The quality of life in anemic patients with chronic heart failure, depending on the presence or absence of chronic kidney disease

Abstract

Chronic heart failure is one of the most common and prognostically adverse disease of cardiovascular system. Presence of chronic heart failure is associated with poor quality of life. Quality of life in patients with chronic heart failure is largely determined by the presence of comorbidity. An important role is given to anemic syndrome, which is considered to be a marker of increased risk of death, quality of life disorders in patients with chronic heart failure.

Aim of the study - to evaluate the quality of life for patients with anemia varying grade of severity developed on the background of chronic heart failure, depending on the presence or absence of chronic kidney disease, using a questionnaire FACT-An.

140 patients with II-IV functional class of chronic heart failure due to ischemic heart disease were investigated. First group consists of 71 anemic patients with chronic heart failure and chronic kidney disease, second - 69 anemic patients with chronic heart failure without chronic kidney disease. Functional class of chronic heart failure installed according to the classification of the New York Heart Association (NYHA). Diagnosis of chronic kidney disease was determinate according to NKF K/DOQI, 2006. Patients were divided by grades according to WHO classification. Questionnaire FACT-An was used to assess the quality of life in anemic patients with chronic heart failure with or without chronic kidney disease.

Results. Study of quality of life in both groups of patients showed a statistically significant reduction in the parameters of physical, emotional, functional, social well-being, scale of weakness, total scale of weakness and anemia with an increase in the severity of anemia. In comparing the parameters of quality of life in patients with the same degree of anemia severity depends on the presence or absence of renal dysfunction observed differences. Thus in anemic patients with chronic heart failure and chronic kidney disease observed a significant reduction in the parameters of physical, emotional, functional well-being, scale of weakness, total scale of weakness and anemia compared with patients with chronic heart failure without chronic kidney disease in the presence of the same degree of anemia severity. In anemic patients with chronic heart failure were found direct correlations between the level of red blood cells and functional well-being (r = 0,20), total scale of weakness and anemia (r = 0,23); hemoglobin level and scale of anemia (r = 0, 17), color index and social well-being (r = 0,27). In anemic patients with chronic heart failure and chronic kidney disease were found direct correlations between hemoglobin and physical well-being (r = 0,37), scale of weakness (r = 0,22), total scale of weakness and anemia (r = 0,23); color index and physical well-being (r = 0, 39), emotional well-being (r = 0,23), functional well-being (r = 0,34), scale of weakness (r = 0,35).

Conclusions. Presence of anemic syndrome in patients with chronic heart failure associated with reduced quality of life parameters regardless of the presence or absence of concomitant chronic kidney disease. Low hemoglobin levels were associated with a reduction of the physical state parameters, the total scale of weakness and anemia in both groups of patients. Color level had a significant effect on the physical, functional, and emotional well-being in patients with chronic heart failure, chronic kidney disease and anemia, as well as the level of social and family relationships in patients with anemia, developed on a base of chronic heart failure without chronic kidney disease.

Key words: chronic heart failure, chronic kidney disease, anemia, quality of life.