Predictors of Quality of Life in Patients Undergoing Hemodialysis for Chronic Kidney Disease (CKD) in Surabaya, Indonesia
Abstract
Introduction: Hemodialysis is the primary therapy for patients with end-stage chronic kidney disease. While it provides essential medical benefits, the procedure also imposes significant physical, psychological, and social challenges, impacting patients’ quality of life. The quality of life of patients with Chronic Kidney Disease (CKD) is influenced by various factors, including individual characteristics such as age, nutritional status, duration of hemodialysis, occupation, gender, and level of education. Advanced age is often associated with a decline in physiological function and an increased risk of complications. Poor nutritional status or malnutrition is linked to higher morbidity and mortality rates. The length of time a patient undergoes hemodialysis may also affect their physical and psychological adaptation, either positively or negatively. This study aims to analyze the predictive factors influencing the quality of life among chronic kidney disease patients undergoing hemodialysis at a private hospital in Surabaya, Indonesia.
Methods: This study employed a cross-sectional design involving 160 respondents selected through probability random sampling. Data were collected using the Kidney Disease Quality of Life-Short Form (KDQOL-SF) questionnaire and analyzed using multiple logistic regression to determine significant factors associated with quality of life.
Results: The analysis revealed significant associations between age (p=0.001; OR=0.008), duration of hemodialysis (p=0.010; OR=25.916), and nutritional status (p=0.000; OR=0.003) with patients’ quality of life. Patients with poor nutritional status and prolonged hemodialysis duration were at a higher risk of experiencing a decline in quality of life.
Conclusion: This study underscores the importance of routine nutritional assessments and targeted monitoring for elderly patients and those with long-term hemodialysis. These strategies are critical to optimizing the quality of life among hemodialysis patients.
References
Kalantar-Zadeh K, Jafar TH, Nitsch D, Neuen BL, Perkovic V. Chronic kidney disease. The lancet. 2021;398(10302):786-802. DOI: 10.1016/S0140-6736(21)00519-5
Clavé S, Tsimaratos M, Boucekine M, Ranchin B, Salomon R, Dunand O, et al. Quality of life in adolescents with chronic kidney disease who initiate haemodialysis treatment. BMC nephrology. 2019;20:1-10. DOI: https://doi.org/10.1186/s12882-019-1365-3
Eckardt K-U, Delgado C, Heerspink HJ, Pecoits-Filho R, Ricardo AC, Stengel B, et al. Trends and perspectives for improving quality of chronic kidney disease care: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney international. 2023;104(5):888-903. DOI. https://doi.org/10.1016/j.kint.2023.05.013
Laws R, Tapsell L, Kelly J. Nutritional status and its relationship to quality of life in a sample of chronic hemodialysis patients. Journal of Renal Nutrition. 2000;10(3):139-47. DOI: https://doi.org/10.1053/jren.2000.7412
Eldoushy EE, Shehata H. Impact of Maintenance Hemodialysis on Patients' Lifestyle and Well-Being. Int J Novel Res Healthc Nurs. 2019;6(1):523-42.
Su G, Saglimbene V, Wong G, Natale P, Ruospo M, Craig JC, et al. Healthy lifestyle and mortality among adults receiving hemodialysis: the DIET-HD study. American journal of kidney diseases. 2022;79(5):688-98. e1. DOI: https://doi.org/10.1053/j.ajkd.2021.07.022
Milenkova M, Trajceska L, Mladenovska D, Bedzeti B, Pushevski V, Rambabova-Busletikj I, et al. Family Support is Crucial for Dialysis Patients Compliance to Treatment and Quality of Life. Journal of Morphological Sciences. 2020;3(2):29-36.
Al Salmi I, Kamble P, Lazarus ER, D’Souza MS, Al Maimani Y, Hannawi S. Kidney Disease?Specific Quality of Life among Patients on Hemodialysis. International journal of nephrology. 2021;2021(1):8876559. DOI : https://doi.org/10.1155/2021/8876559
Hasan LM, Shaheen DA, El Kannishy GA, Sayed-Ahmed NA, Abd El Wahab AM. Is health-related quality of life associated with adequacy of hemodialysis in chronic kidney disease patients? BMC nephrology. 2021;22:1-12. DOI: https://doi.org/10.1186/s12882-021-02539-z
Adiningrum N, Andayani TM, Kristina SA. Analisis faktor klinik terhadap kualitas hidup pasien Hemodialisis di RSUD dr. Loekmono Hadi Kudus. J Farm Dan Ilmu Kefarmasian Indones. 2021;8(1):29.
Kattah AG, Garovic VD. Understanding sex differences in progression and prognosis of chronic kidney disease. Annals of translational medicine. 2020;8(14). DOI: https://doi.org/10.21037/atm.2020.03.62
?ukanovi? L, Dimkovi? N, Ležai? V. Sex-specific differences in the epidemiology, progression, and outcomes of chronic kidney disease. Srpski arhiv za celokupno lekarstvo. 2023(00):71. DOI: https://doi.org/10.2298/SARH230321071D
Viramontes-Hörner D, Pittman Z, Selby NM, Taal MW. Impact of malnutrition on health-related quality of life in persons receiving dialysis: a prospective study. British Journal of Nutrition. 2022;127(11):1647-55. DOI: https://doi.org/10.1017/S000711452100249X
Nagy E, Mahmoud M, El?kannishy G, Sayed?Ahmed N. Impact of malnutrition on health?related quality of life in patients on maintenance hemodialysis. Therapeutic Apheresis and Dialysis. 2021;25(4):467-74.DOI: https://doi.org/10.1111/1744-9987.13588
Visiedo L, Rey L, Rivas F, López F, Tortajada B, Giménez R, et al. The impact of nutritional status on health-related quality of life in hemodialysis patients. Scientific Reports. 2022;12(1):3029.DOI: https://doi.org/10.1038/s41598-022-07055-0
Iseki K. Nutrition and quality of life in chronic kidney disease patients: a practical approach for salt restriction. Kidney research and clinical practice. 2022;41(6):657.DOI: https://doi.org/10.23876/j.krcp.21.203
Cai Q, Dekker LH, Vinke PC, Corpeleijn E, Bakker SJ, de Borst MH, et al. Diet quality and incident chronic kidney disease in the general population: The Lifelines Cohort Study. Clinical Nutrition. 2021;40(9):5099-105. DOI: https://doi.org/10.1016/j.clnu.2021.07.033
Daniel SC, Azuero A, Gutierrez OM, Heaton K. Examining the relationship between nutrition, quality of life, and depression in hemodialysis patients. Quality of life research. 2021;30:759-68. DOI: https://doi.org/10.1007/s11136-020-02684-2
Sembiring LP, Hanifah ZN. Hubungan status gizi terhadap kualitas hidup pada pasien penyakit ginjal kronik yang menjalani hemodialisis di RSUD Arifin Achmad Provinsi Riau. J Ilmu Kedokt. 2021;14(2):103.
Bashar MA, Haque ME, Islam MZ. Nutritional Status and Health Related Quality of Life Of Chronic Kidney Disease Patients. Journal of Preventive and Social Medicine. 2021;40(2):44-51. DOI: https://doi.org/10.3329/jopsom.v40i2.61796
Pawlaczyk W, Rogowski L, Kowalska J, Stefa?ska M, Go??biowski T, Mazanowska O, et al. Assessment of the nutritional status and quality of life in chronic kidney disease and kidney transplant patients: a comparative analysis. Nutrients. 2022;14(22):4814. DOI: https://doi.org/10.3390/nu14224814
Hamidianshirazi M, Shafiee M, Ekramzadeh M, Jahromi MT, Nikaein F. Diet therapy along with nutrition education can improve renal function in people with stages 3–4 chronic kidney disease who do not have diabetes: a randomised controlled trial. British Journal of Nutrition. 2023;129(11):1877-87.DOI: 10.1017/S0007114522002094
Magalhães FG, Goulart RMM, Prearo LC. The impact of a nutrition intervention program targeting elderly people with chronic kidney disease. Ciencia & saude coletiva. 2018;23:2555-64.DOI : https://doi.org/10.1590/1413-81232018238.23972016
Chan W. Chronic kidney disease and nutrition support. Nutrition in Clinical Practice. 2021;36(2):312-30. DOI: https://doi.org/10.1002/ncp.10658
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