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THE IMPACT OF HEMODIALYSIS ON THE QUALITY OF LIFE OF
END-STAGE RENAL DISEASE PATIENTS: A STUDY OF DURATION,
GENDER, AND ASSOCIATED FACTORS
Abdujabborov Jamshidbek
Omonov Jamshid
Tursunboev Ulugbek
Kushboeva Shabnam
Abdurakhmanova Sayyora
https://doi.org/10.5281/zenodo.15192812
Introduction
Chronic kidney disease (CKD) often progresses to end-stage renal disease
(ESRD), a condition requiring renal replacement therapy such as hemodialysis
(HD). The advent of HD has significantly increased the life expectancy of patients
with ESRD, extending survival by an average of 10–12 years. However, the
prospect of lifelong dialysis treatment remains a source of physical,
psychological, and social distress for many patients. The treatment involves
considerable lifestyle adjustments, including restricted mobility, strict dietary
controls, limited fluid intake, dependence on medical technology, and a marked
reduction in the quality of life (QoL). A comprehensive understanding of these
factors, particularly how they influence the physical and mental health of
patients, is crucial for improving the overall experience of individuals
undergoing HD. This study aims to assess the quality of life of ESRD patients on
hemodialysis, examining the role of gender, the duration of dialysis, and other
modifiable and non-modifiable factors in shaping the patients’ QoL.
Materials and Methods
The study was conducted at the Republican Specialized Scientific and
Practical Medical Center for Nephrology and Kidney Transplantation, with a
sample of 120 ESRD patients undergoing HD. The median age of participants
was 55.2 years (±17.4 years), with a range from 27 to 77 years. The sample
comprised 57 men and 63 women. The primary causes of ESRD included chronic
glomerulonephritis (65%), diabetes mellitus (31.7%), and polycystic kidney
disease (3.3%). Participants were grouped based on the duration of their
dialysis treatment: Group 1 (HD duration up to 1 year, n=35), Group 2 (2–9
years, n=65), and Group 3 (more than 10 years, n=20).
The quality of life was measured using the 36-Item Short Form Survey (SF-
36), a widely used tool for evaluating health status across eight domains:
physical functioning, role-physical functioning, bodily pain, general health,
vitality, social functioning, emotional role functioning, and mental health. The
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scores for each domain range from 0 to 100, with higher scores indicating better
quality of life. Data were analyzed to compare QoL scores across gender and the
duration of HD treatment.
Results
The study revealed significant differences in QoL scores between male and
female patients. Women scored higher on the "General Health" (GH) scale (56.8
± 12.3 vs. 44.8 ± 24.3, p < 0.01), while men scored higher on the "Social
Functioning" (SF) scale (59.3 ± 26.5 vs. 65.4 ± 27.2, p < 0.05).
When comparing the impact of dialysis duration, patients with shorter
dialysis durations (Group 1, less than 1 year) showed the lowest scores across
several physical health scales, particularly in "Role-Physical Functioning" (RP)
and "Emotional Role Functioning" (RE), with mean scores of 30.8 ± 15.1 and
22.1 ± 10.8, respectively. In contrast, patients in Group 2 (2-9 years on dialysis)
exhibited higher scores, particularly in the "Bodily Pain" (BP) scale (56.1 ± 17.8,
p < 0.01), while Group 3 (more than 10 years on dialysis) had the lowest scores
in multiple domains, including RP and RE. The results suggest that while initial
treatment may cause significant physical and emotional strain, patients with
longer dialysis experience tend to adapt better to these challenges, though their
overall quality of life remains compromised.
In terms of patient complaints, the most common issues included loss of
strength (63.3%), weakness and dizziness (60%), muscle pain (55.8%), and skin
itching (50%). Patients also reported significant limitations in mobility (83.3%)
and fluid intake (70%), as well as social isolation (50%).
Discussion
The findings of this study highlight the considerable impact of hemodialysis
on the quality of life of ESRD patients. While medical advancements have
improved the prognosis for many patients, the physical and psychological toll of
long-term dialysis remains high. The sharp decline in QoL in patients undergoing
dialysis for less than a year is particularly concerning, as these patients struggle
with the abrupt lifestyle changes and the emotional burden of their condition. A
lack of comprehensive understanding about the disease and treatment options,
coupled with social isolation and depression, often exacerbates these challenges.
In contrast, patients with longer dialysis durations exhibited better
adaptation, though still reporting significant QoL limitations. The improvement
in some domains, such as pain management, highlights the role of healthcare
professionals in addressing specific symptoms over time.
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The gender differences observed in the study suggest that women may
experience poorer general health perceptions, which could be attributed to the
added psychological burden of caregiving responsibilities or societal
expectations. Meanwhile, men reported better social functioning, which may
reflect different coping mechanisms or support systems.
To improve the overall quality of life for dialysis patients, it is essential to
address both physical and psychological health. The implementation of
educational programs, such as "Hemodialysis Schools," could help provide
patients with the necessary information about their disease and treatment,
reducing anxiety and depression. Additionally, a multidisciplinary approach
involving dietitians, psychologists, and various medical specialists could
enhance patient outcomes by addressing the complex and multifaceted needs of
these individuals.
Conclusion
This study underscores the significant impact of hemodialysis on the
quality of life of ESRD patients, with patients undergoing dialysis for less than a
year facing the most severe challenges. The findings highlight the importance of
early patient education, continuous emotional support, and integrated care to
address both the physical and psychological needs of patients. Future research
should focus on exploring tailored interventions to improve patient adaptation,
particularly in the early stages of treatment, and to investigate the long-term
effects of hemodialysis on QoL in diverse patient populations.
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