Prevalence of Knee Pain and Its Relation to Depression, Anxiety, and Health-Related Quality of Life Among Maintenance Hemodialysis Patients

<b>Background/Objectives</b>: Knee pain in hemodialysis (HD) patients might affect health-related quality of life (HRQoL) and may be related to anxiety and depressive symptoms. The aim of this study was to assess the prevalence of knee pain in chronic HD patients and to determine its relationship with anxiety, depression, and HRQoL, <b>Methods</b>: This multicenter cross-sectional study was carried out on chronic HD patients. Sociodemographic, clinical, and therapeutic data were collected. The Knee Pain Screening Tool (KNEST) was used to screen for knee pain. Patients with knee pain were instructed to complete the visual analog scale (VAS) for pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The patients also completed an Arabic-language version of the Hospital Anxiety and Depression Scale (HADS) and the Kidney Disease Quality of Life-36 (KDQOL-36™) questionnaire. <b>Results</b>: This study included 271 chronic HD patients; the median age was 51 (IQR 21) years, and most of them were males (59%). Of them, 158 had knee pain. Those with knee pain were more likely to have anxiety compared to those without (<i>p</i> = 0.002) and significantly lower scores on the symptom/problem (<i>p</i> = 0.03) and burden of kidney disease domains (<i>p</i> = 0.047) and the physical health (<i>p</i> < 0.001) and mental health components (<i>p</i> = 0.001). Furthermore, those with moderate to severe knee pain were more likely to experience anxiety (<i>p</i> = 0.001) and depression (<i>p</i> = 0.005) and have a lower physical health composite (PHC) than those with mild knee pain (<i>p</i> = 0.046). <b>Conclusions</b>: HD patients have a significant prevalence of knee pain that is usually associated with anxiety and leads to worse HRQoL than those without knee pain.