# Evaluation of Factors Affecting the Health-Related Quality of Life in End-Stage Renal Disease Patients Receiving Hemodialysis Treatment in Northern Cyprus

## TL;DR

This study evaluates how factors like gender, employment, and comorbidities affect the quality of life of hemodialysis patients in Northern Cyprus.

## Contribution

The study identifies novel predictors of health-related quality of life in hemodialysis patients using a cross-sectional design in Northern Cyprus.

## Key findings

- Females, unemployed patients, and those with more comorbidities had significantly lower quality of life scores.
- Gender, age, comorbidities, and patient care were identified as significant predictors of HR-QoL scores.
- Most patients had low scores on key quality of life dimensions like disease burden and mental health.

## Abstract

Introduction

Health-related quality of life (HR-QoL) is recognized as an important predictor of mortality and morbidity in end-stage renal disease (ESRD) patients receiving hemodialysis (HD). The goal of this study was to obtain HR-QoL scores using the Kidney Disease and Quality of Life questionnaire (KDQOL-36TM) (RAND Corporation, Santa Monica, CA) and to assess the factors affecting HR-QoL in ESRD patients receiving HD.

Methods

A multicenter cross-sectional study was performed using the KDQOL-36TM for the assessment of HR-QoL of ESRD patients receiving HD in Northern Cypriot state hospitals. Alongside KDQOL-36TM scores for assessing HR-QoL, sociodemographic as well as relevant laboratory data were collected. Spearman Correlations and multiple linear regression analyses using the 'stepwise' method were carried out to identify predictors of HR-QoL. Nonparametric tests were used to determine significantly (p<0.05) associated variables. Ethical approvals were received from the Northern Cypriot Ministry of Health and Eastern Mediterranean University Research and Publication Ethics Boards.

Results

One hundred and thirty-eight participants were recruited in this study, corresponding to 85.1% of the total study population. Participants had a mean age of 66.49 ± 13.35. 65.2% of the participants were males. Participants had low scores on most dimensions of quality of life, namely, Burden of Disease, Physical Component Summary (PCS), and Mental Component Summary (MCS) subscales. Particularly, females, unemployed patients, and patients with more comorbidities had significantly lower scores (p=0.003, p<0.001, and p=0.005, respectively). Spearman correlation analyses revealed multiple significant moderate correlations between sociodemographic data, laboratory variables, and scores. Furthermore, multiple linear regression analysis identified gender (p=0.006), total number of comorbidities (p=0.005), age (p<0.001), and patient care (p=0.019) as significant predictors of KDQOL-36TM scores.

Conclusion

This study has shown that the quality of life of hemodialysis patients was highly impaired. Gender, current employment status, and presence of comorbidities were all significant independent factors affecting HR-QoL mean scores. Lastly, further studies regarding the implementation of routine HR-QoL surveillance and targeted interventions are required to better understand their potential therapeutic benefits.