Effect of aging in the perception of health related quality of life, dialysis adequacy, iron status, inflammation and nutritional markers in end stage renal disease patients under online hemodiafiltration

Introduction and Aims: A high proportion of dialysis patients are older, raising a major challenge to health care systems, as they often show several comorbidities, poor functional status, depression and they often avoid personal and social involvement. There is a lack of information about the effect of aging in patients’ perception of health quality of life (HRQOL), and in clinical and analytical characteristics of dialysis patients, particularly in end-stage renal disease (ESRD) patients under online-hemodiafiltration (OL-HDF). We aimed to evaluate how aging could influence patients’ perception of HRQOL, as well as, the effect of aging on dialysis adequacy and in hematological, iron status, inflammatory and nutritional markers. Methods: In this transversal study were enrolled 322 ESRD patients under OL-HDF (59.63% males; 64.9 ± 14.3 years old). Data about comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected from patient’s records. Moreover, HRQOL score, by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF), were assessed. Results: Analyzing the results according to quartiles of age, significant differences were found for some parameters evaluated by the KDQOL-SF instrument, namely for work status, physical functioning and role-physical, which decreased with increasing age. We also found a higher proportion of diabetic patients, a decrease in creatinine, iron, albumin serum levels, transferrin saturation and nPCR, with increasing age. Moreover, significant negative correlations were found between age and MCHC (r=-0.190; p=0.001), iron (r=-0.207; p<0.001), transferrin saturation (r=-0.166; p=0.004), albumin (r=-0.190; p<0.001), nPCR (r=-0.191; r=0.001), work status (r=-0.199; p<0.001), physical functioning (r=-0.323; p<0.001) and role-physical (r=-0.182; p=0.001). Conclusions: In conclusion, our results showed that aging is associated with a decreased work status, physical functioning and role-physical, with a decreased dialysis adequacy, iron availability and nutritional status, and with diabetes and with the use of central venous catheter, as the vascular access. The knowledge of these changes associated with aging, which have impact in the quality of life of the patients, could be useful in their management.