Association of Socio-Demographic Factors Affecting the Quality of Life in Patients with Chronic Kidney Disease on Hemodialysis: A Cross-Sectional Study
Abstract
Introduction: Chronic kidney disease (CKD) poses a substantial global health challenge, affecting 8% to 16% of the population. The quality of life (QOL) for CKD patients, especially those undergoing hemodialysis (HD), is influenced by socio-demographic factors. Objective: This observational study aimed to evaluate QOL among CKD patients undergoing HD at Surabaya Islamic Hospital and explore potential influencing factors. Methods: Using purposive sampling, 178 CKD patients aged 18 years and above participated. Socio-demographic data and QOL were evaluated using the WHOQOL-BREF scale. Results: Majority were elderly (39.9%), female (65.2%), Muslim (87.6%), with 43.8% earning Rp. 4,500,000 or more, and 52.8% having less than high school education. The study unveiled varied QOL patterns across domains. Physical QOL was high for 46.1%, while 47.2% reported low psychological QOL. Social QOL was balanced, but environmental QOL was low for 43.8%. Overall, 57.3% reported high QOL. Statistical analysis revealed significant associations between QOL and age, income, religion, and education (p < 0.05). Gender showed no significant relationship (p = 0.138 > 0.05). In conclusion, age, income, religion, and education significantly influenced QOL among CKD patients undergoing HD, highlighting the importance of tailored interventions to enhance patient outcomes. Gender, however, did not play a significant role in QOL disparities among this population.
Keywords:
Chronic Kidney Disease, Hemodialysis, Quality of Life
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References
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Anu, V. K., Pushpa, P., & Kumar, S. S. (2013). Quality of Life of Patients undergong Haemodialysis at BP Koirala Institute of Health Sciences. Journal of Manmohan Memorial Institute of Health Sciences, 1(2), 19-25. https://doi.org/10.3126/jmmihs.v1i2.9904
Belinda, B., & Dewi, Z. L. (2021). Exploring Self-Regulation of Patients with Chronic Kidney Disease Undergoing Hemodialysis. Jurnal Psikologi, 48(2), 118-132.https://doi.org/10.22146/jpsi.61144
Bravin, A. M., Trettene, A. D. S., Andrade, L. G. M. D., & Popim, R. C. (2019). Benefits of spirituality and/or religiosity in patients with Chronic Kidney Disease: an integrative review. Revista Brasileira de Enfermagem, 72, 541-551. https://doi.org/10.1590/0034-7167-2018-0051
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Hemati, Z., Alidosti, M., Sharifirad, G., & Kargar, M. (2013). The relationship between depression and quality of life among hemodialysis patients in Chaharmahal and Bakhtiari province in the year 2011. Journal of education and health promotion, 2(1), 6. https://doi.org/10.4103/2277-9531.106645
Ismail, I. A., Pernadi, N. L., & Febriyanti, A. (2022). How to grab and determine the size of the sample for research. International Journal of Academic and Applied Research (IJAAR), 6(9), 88-92. http://repository.unp.ac.id/id/eprint/41155
Javanbakht, M., Abolhasani, F., Mashayekhi, A., Baradaran, H. R., & Jahangiri noudeh, Y. (2012). Health related quality of life in patients with type 2 diabetes mellitus in Iran: a national survey. https://doi.org/10.1371/journal.pone.0044526
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Ma, H. Y., Chen, S., & Du, Y. (2021). Estrogen and estrogen receptors in kidney diseases. Renal failure, 43(1), 619-642.https://doi.org/10.1080/0886022X.2021.1901739
Mahato, S. K. S., Apidechkul, T., Sriwongpan, P., Hada, R., Sharma, G. N., Nayak, S. K., & Mahato, R. K. (2020). Factors associated with quality of life among chronic kidney disease patients in Nepal: a cross-sectional study. Health and Quality of Life Outcomes, 18, 1-14.https://doi.org/10.1186/s12955-020-01458-1
Manavalan, M., Majumdar, A., Kumar, K. H., & Priyamvada, P. S. (2017). Assessment of health-related quality of life and its determinants in patients with chronic kidney disease. Indian journal of nephrology, 27(1), 37-43. https://doi.org/10.4103/0971-4065.179205
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Medina, D., Mehay, D., & Arnold, A. C. (2020). Sex differences in cardiovascular actions of the renin–angiotensin system. Clinical Autonomic Research, 30(5), 393-408. https://doi.org/10.1007/s10286-020-00720-2
Merom, D., Sinnreich, R., Aboudi, V., Kark, J. D., & Nassar, H. (2012). Lifestyle physical activity among urban Palestinians and Israelis: a cross-sectional comparison in the Palestinian-Israeli Jerusalem risk factor study. BMC public health, 12, 1-13. https://doi.org/10.1186/1471-2458-12-90
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Mousa, I., Ataba, R., Al-ali, K., Alkaiyat, A., & Zyoud, S. E. H. (2018). Dialysis-related factors affecting self-efficacy and quality of life in patients on haemodialysis: a cross-sectional study from Palestine. Renal Replacement Therapy, 4, 1-12.https://doi.org/10.1186/s41100-018-0162-y
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Nurbadriyah, W. D., Nursalam, N., Widyawati, I. Y., & Kurniawan, A. W. (2023). Factors associated with quality of life among patients undergoing hemodialysis in Indonesia. Jurnal Ners, 18(3), 252-256. https://doi.org/10.20473/jn.v18i3.46280
Park, J. Y., Jung, J., Kim, Y. C., Lee, H., Kim, E., Kim, Y. S., ... & Lee, J. P. (2021). Effects of residential greenness on clinical outcomes of patients with chronic kidney disease: a large-scale observation study. Kidney Research and Clinical Practice, 40(2), 272.–281. https://doi.org/10.23876/j.krcp.20.224
Pilger, C., Santos, R. O. P. D., Lentsck, M. H., Marques, S., & Kusumota, L. (2017). Spiritual well-being and quality of life of older adults in hemodialysis. Revista brasileira de enfermagem, 70(4), 689-696.https://doi.org/10.1590/0034-7167-2017-0006
Ravindran, A., Sunny, A., Kunnath, R. P., & Divakaran, B. (2020). Assessment of quality of life among end-stage renal disease patients undergoing maintenance hemodialysis. Indian journal of palliative care, 26(1), 47. https://doi.org/10.4103/IJPC.IJPC_141_19
Saffari, M., Pakpour, A. H., Naderi, M. K., Koenig, H. G., Baldacchino, D. R., & Piper, C. N. (2013). Spiritual coping, religiosity and quality of life: a study on M uslim patients undergoing haemodialysis. Nephrology, 18(4), 269-275. https://doi.org/10.1111/nep.12041
Tannor, E. K., Norman, B. R., Adusei, K. K., Sarfo, F. S., Davids, M. R., & Bedu-Addo, G. (2019). Quality of life among patients with moderate to advanced chronic kidney disease in Ghana-a single centre study. BMC nephrology, 20, 1-10. https://doi.org/10.1186/s12882-019-1316-z
van der Burgh, A. C., Rizopoulos, D., Ikram, M. A., Hoorn, E. J., & Chaker, L. (2021). Determinants of the evolution of kidney function with age. Kidney international reports, 6(12), 3054-3063. https://doi.org/10.1016/j.ekir.2021.10.006
Waleekhachonloet, O., Rattachotphanit, T., Chanasopon, S., Ausornsagian, W., Kajanasilp, J., & Suwattanasilp, A. (2018). Financial burdens on patients with end stage renal disease receiving renal replacement therapy. Isan J Pharmaceutical Sci, 14(4), 79-87.
WHO. (2012). WHOQOL - Measuring Quality of Life| The World Health Organization. https://www.who.int/tools/whoqol
Yuliawati, A. N., Ratnasari, P. M. D., & Maharani, N. L. P. S. (2023). Quality of life in end-stage renal disease patients undergoing hemodialysis and its affecting factors in a hemodialysis unit of general hospital denpasar. Borneo Journal of Pharmacy, 6(3), 320-329. https://doi.org/10.33084/bjop.v6i3.3907
Zyoud, S. E. H., Daraghmeh, D. N., Mezyed, D. O., Khdeir, R. L., Sawafta, M. N., Ayaseh, N. A., ... & Al-Jabi, S. W. (2016). Factors affecting quality of life in patients on haemodialysis: a cross-sectional study from Palestine. BMC nephrology, 17, 1-12. https://doi.org/10.1186/s12882-016-0257-z
Al Salmi, I., Kamble, P., Lazarus, E. R., D’Souza, M. S., Al Maimani, Y., & Hannawi, S. (2021). Kidney Disease‐Specific Quality of Life among Patients on Hemodialysis. International journal of nephrology, 2021(1), 8876559. 1–8. https://doi.org/10.1155/2021/8876559
Anees, M., Batool, S., Imtiaz, M., & Ibrahim, M. (2018). Socio-economic factors affecting quality of life of Hemodialysis patients and its effects on mortality. Pakistan journal of medical sciences, 34(4), 811. https://doi.org/10.12669/pjms.344.15284
Anu, V. K., Pushpa, P., & Kumar, S. S. (2013). Quality of Life of Patients undergong Haemodialysis at BP Koirala Institute of Health Sciences. Journal of Manmohan Memorial Institute of Health Sciences, 1(2), 19-25. https://doi.org/10.3126/jmmihs.v1i2.9904
Belinda, B., & Dewi, Z. L. (2021). Exploring Self-Regulation of Patients with Chronic Kidney Disease Undergoing Hemodialysis. Jurnal Psikologi, 48(2), 118-132.https://doi.org/10.22146/jpsi.61144
Bravin, A. M., Trettene, A. D. S., Andrade, L. G. M. D., & Popim, R. C. (2019). Benefits of spirituality and/or religiosity in patients with Chronic Kidney Disease: an integrative review. Revista Brasileira de Enfermagem, 72, 541-551. https://doi.org/10.1590/0034-7167-2018-0051
Brown, M. A., Collett, G. K., Josland, E. A., Foote, C., Li, Q., & Brennan, F. P. (2015). CKD in elderly patients managed without dialysis: survival, symptoms, and quality of life. Clinical Journal of the American Society of Nephrology, 10(2), 260-268. https://doi.org/10.2215/CJN.03330414
Chang-Panesso, M. (2021). Acute kidney injury and aging. Pediatric Nephrology, 36(10), 2997-3006. https://doi.org/10.1007/s00467-020-04849-0
Chen, T. K., Knicely, D. H., & Grams, M. E. (2019). Chronic kidney disease diagnosis and management: a review. Jama, 322(13), 1294-1304. https://doi.org/10.1001/jama.2019.14745
Dewi, N. P. R. A., Kandarini, Y., Sajinadiyasa, I. G. K., & Triharnoto, T. (2020). Assessment of quality of life among chronic kidney disease patients undergoing hemodialysis in Sanglah General Hospital, Denpasar from April-May 2017 using EQ-5D-5L questionnaire. Intisari Sains Medis, 11(1), 104-108.https://doi.org/10.15562/ism.v11i1.172
El-Habashi, A. F., El-Agroudy, A. E., Jaradat, A., Alnasser, Z. H., Almajrafi, H. H., Alharbi, R. H., ... & Alqahtani, A. M. (2020). Quality of life and its determinants among hemodialysis patients: A single-center study. Saudi Journal of Kidney Diseases and Transplantation, 31(2), 460-472. https://doi.org/10.4103/1319-2442.284022
El Kass, S. D. M. A., El-Senousy, T. A., & Jumaa, N. A. (2020). Factors Affecting Quality of Life among Patients Undergoing Hemodialysis Program in Gaza Strip. International Journal of Caring Sciences, 13(2).1221–1229. https://search.proquest.com/scholarly-journals/factors-affecting-quality-life-among-patients/docview/2462488073/se-2?accountid=25704
García-Llana, H., Remor, E., & Selgas, R. (2013). Adherence to treatment, emotional state and quality of life in patients with end-stage renal disease undergoing dialysis. Psicothema, 25(1), 79-86.https://doi.org/10.7334/psicothema2012.96
Ghimire, S., & Lopchan, M. (2017). Quality of life of hemodialysis patients in selected teaching hospitals of Chitwan. Journal of Chitwan Medical College, 7(1), 29-34.https://doi.org/10.3126/jcmc.v7i1.17367
Hemati, Z., Alidosti, M., Sharifirad, G., & Kargar, M. (2013). The relationship between depression and quality of life among hemodialysis patients in Chaharmahal and Bakhtiari province in the year 2011. Journal of education and health promotion, 2(1), 6. https://doi.org/10.4103/2277-9531.106645
Ismail, I. A., Pernadi, N. L., & Febriyanti, A. (2022). How to grab and determine the size of the sample for research. International Journal of Academic and Applied Research (IJAAR), 6(9), 88-92. http://repository.unp.ac.id/id/eprint/41155
Javanbakht, M., Abolhasani, F., Mashayekhi, A., Baradaran, H. R., & Jahangiri noudeh, Y. (2012). Health related quality of life in patients with type 2 diabetes mellitus in Iran: a national survey. https://doi.org/10.1371/journal.pone.0044526
Kefale, B., Alebachew, M., Tadesse, Y., & Engidawork, E. (2019). Quality of life and its predictors among patients with chronic kidney disease: A hospital-based cross sectional study. PloS one, 14(2), e0212184.https://doi.org/10.1371/journal.pone.0212184
Lemos, C. F., Rodrigues, M. P., & Veiga, J. R. P. (2015). Family income is associated with quality of life in patients with chronic kidney disease in the pre-dialysis phase: a cross sectional study. Health and quality of life outcomes, 13, 1-9.https://doi.org/10.1186/s12955-015-0390-6
Liu, Y., Zhang, G.-M.-Y., Peng, X., Li, X., Sun, H., & Chen, L. (2022). Diffusion kurtosis imaging as an imaging biomarker for predicting prognosis in chronic kidney disease patients. Nephrology Dialysis Transplantation, 37(8), 1451–1460. https://doi.org/10.1093/ndt/gfab229
Ma, H. Y., Chen, S., & Du, Y. (2021). Estrogen and estrogen receptors in kidney diseases. Renal failure, 43(1), 619-642.https://doi.org/10.1080/0886022X.2021.1901739
Mahato, S. K. S., Apidechkul, T., Sriwongpan, P., Hada, R., Sharma, G. N., Nayak, S. K., & Mahato, R. K. (2020). Factors associated with quality of life among chronic kidney disease patients in Nepal: a cross-sectional study. Health and Quality of Life Outcomes, 18, 1-14.https://doi.org/10.1186/s12955-020-01458-1
Manavalan, M., Majumdar, A., Kumar, K. H., & Priyamvada, P. S. (2017). Assessment of health-related quality of life and its determinants in patients with chronic kidney disease. Indian journal of nephrology, 27(1), 37-43. https://doi.org/10.4103/0971-4065.179205
Medical Record Surabaya Islamic Hospital. (2023). Medical Record.
Medina, D., Mehay, D., & Arnold, A. C. (2020). Sex differences in cardiovascular actions of the renin–angiotensin system. Clinical Autonomic Research, 30(5), 393-408. https://doi.org/10.1007/s10286-020-00720-2
Merom, D., Sinnreich, R., Aboudi, V., Kark, J. D., & Nassar, H. (2012). Lifestyle physical activity among urban Palestinians and Israelis: a cross-sectional comparison in the Palestinian-Israeli Jerusalem risk factor study. BMC public health, 12, 1-13. https://doi.org/10.1186/1471-2458-12-90
Ministry of Health of Indonesia. (2018). Laporan Riset Kesehatan Dasar 2018.
Mousa, I., Ataba, R., Al-ali, K., Alkaiyat, A., & Zyoud, S. E. H. (2018). Dialysis-related factors affecting self-efficacy and quality of life in patients on haemodialysis: a cross-sectional study from Palestine. Renal Replacement Therapy, 4, 1-12.https://doi.org/10.1186/s41100-018-0162-y
Mullens, W., Damman, K., Testani, J. M., Martens, P., Mueller, C., Lassus, J., ... & Coats, A. (2020). Evaluation of kidney function throughout the heart failure trajectory–a position statement from the Heart Failure Association of the European Society of Cardiology. European journal of heart failure, 22(4), 584-603. https://doi.org/10.1002/ejhf.1697
Nurbadriyah, W. D., Nursalam, N., Widyawati, I. Y., & Kurniawan, A. W. (2023). Factors associated with quality of life among patients undergoing hemodialysis in Indonesia. Jurnal Ners, 18(3), 252-256. https://doi.org/10.20473/jn.v18i3.46280
Park, J. Y., Jung, J., Kim, Y. C., Lee, H., Kim, E., Kim, Y. S., ... & Lee, J. P. (2021). Effects of residential greenness on clinical outcomes of patients with chronic kidney disease: a large-scale observation study. Kidney Research and Clinical Practice, 40(2), 272.–281. https://doi.org/10.23876/j.krcp.20.224
Pilger, C., Santos, R. O. P. D., Lentsck, M. H., Marques, S., & Kusumota, L. (2017). Spiritual well-being and quality of life of older adults in hemodialysis. Revista brasileira de enfermagem, 70(4), 689-696.https://doi.org/10.1590/0034-7167-2017-0006
Ravindran, A., Sunny, A., Kunnath, R. P., & Divakaran, B. (2020). Assessment of quality of life among end-stage renal disease patients undergoing maintenance hemodialysis. Indian journal of palliative care, 26(1), 47. https://doi.org/10.4103/IJPC.IJPC_141_19
Saffari, M., Pakpour, A. H., Naderi, M. K., Koenig, H. G., Baldacchino, D. R., & Piper, C. N. (2013). Spiritual coping, religiosity and quality of life: a study on M uslim patients undergoing haemodialysis. Nephrology, 18(4), 269-275. https://doi.org/10.1111/nep.12041
Tannor, E. K., Norman, B. R., Adusei, K. K., Sarfo, F. S., Davids, M. R., & Bedu-Addo, G. (2019). Quality of life among patients with moderate to advanced chronic kidney disease in Ghana-a single centre study. BMC nephrology, 20, 1-10. https://doi.org/10.1186/s12882-019-1316-z
van der Burgh, A. C., Rizopoulos, D., Ikram, M. A., Hoorn, E. J., & Chaker, L. (2021). Determinants of the evolution of kidney function with age. Kidney international reports, 6(12), 3054-3063. https://doi.org/10.1016/j.ekir.2021.10.006
Waleekhachonloet, O., Rattachotphanit, T., Chanasopon, S., Ausornsagian, W., Kajanasilp, J., & Suwattanasilp, A. (2018). Financial burdens on patients with end stage renal disease receiving renal replacement therapy. Isan J Pharmaceutical Sci, 14(4), 79-87.
WHO. (2012). WHOQOL - Measuring Quality of Life| The World Health Organization. https://www.who.int/tools/whoqol
Yuliawati, A. N., Ratnasari, P. M. D., & Maharani, N. L. P. S. (2023). Quality of life in end-stage renal disease patients undergoing hemodialysis and its affecting factors in a hemodialysis unit of general hospital denpasar. Borneo Journal of Pharmacy, 6(3), 320-329. https://doi.org/10.33084/bjop.v6i3.3907
Zyoud, S. E. H., Daraghmeh, D. N., Mezyed, D. O., Khdeir, R. L., Sawafta, M. N., Ayaseh, N. A., ... & Al-Jabi, S. W. (2016). Factors affecting quality of life in patients on haemodialysis: a cross-sectional study from Palestine. BMC nephrology, 17, 1-12. https://doi.org/10.1186/s12882-016-0257-z
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Huda, A., Said, F., Kanathasan, J., Utami, W., & Mulyani, S. (2024). Association of Socio-Demographic Factors Affecting the Quality of Life in Patients with Chronic Kidney Disease on Hemodialysis: A Cross-Sectional Study. International Journal of Advancement in Life Sciences Research, 7(3), 176-185. https://doi.org/https://doi.org/10.31632/ijalsr.2024.v07i03.016
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