Health-Related Quality of Life and its Determinants Among Patients Undergoing Hemodialysis at a Tertiary Care Hospital in Western Province, Sri Lanka

Chronic kidney disease (CKD) is a significant global health challenge. This condition is particularly prevalent in developing nations like Sri Lanka, where the burden of CKD necessitates hemodialysis (HD) as a life-sustaining therapy. This study aims to assess the health-related quality of life (HRQOL) among HD patients in Sri Lanka and identify key determinants influencing their well-being. A descriptive cross-sectional study was conducted at two dialysis units involving 110 CKD patients undergoing HD. Data were collected using interviewer-administered questionnaires, including the validated kidney disease and quality of life (KDQOL-36TM) tool, which assess both generic and disease-specific HRQOL domains. Findings indicate that the overall HRQOL of participants was below average, with mean scores of 41.91 ± 12.25. The scores across the five subscales of symptoms and problems of kidney disease, effects of kidney disease, burden of kidney disease, physical component summary, and mental component summary were 75.15±14.33, 46.73±20.57, 22.10±19.42, 34.00±8.79 and 31.56±9.74 respectively. Significant associations were identified between HRQOL subscales and various factors, including gender, education level, income, and comorbidities (p<0.05). Male patients reported lower perceived burdens from CKD (p=0.009), while those with higher education levels exhibited better HRQOL scores (p<0.05). Additionally, a higher income was associated with improved HRQOL (p<0.05). Urine output ≥500 ml/day and measuring daily intake were associated with higher HRQOL (p<0.05). Heart failure and symptoms like shortness of breath, edema, ascites, and pulmonary edema were linked to lower HRQOL (p<0.05). These findings underscore the necessity for targeted interventions that address both medical and psychosocial aspects of care to enhance the HRQOL of CKD patients undergoing HD in Sri Lanka.