A Study on the Impact of Adequacy of Maintenance Hemodialysis on Quality of Life in Chronic Kidney Disease Patients

Introduction: The study aimed to evaluate the impact of maintenance urea reduction ratio (URR) adequacy on the quality of life (QOL) in chronic kidney disease (CKD) patients and identify which components of the SF‑36 health survey are the most affected by hemodialysis adequacy. Method: The study involved 50 subjects on maintenance hemodialysis (MHD) for at least 3 months. The QOL was measured using a Short Form (SF)‑36 Health Survey Questionnaire. HD adequacy was measured using spKt/V and urea reduction ratio (URR). Results: Among the 50 patients, 35 (70%) had an AV fistula for vascular access, 9 (18%) had a permcath, equal number of patients 3 (3.9%) had an AV graft and HD catheter. The mean hemoglobin and albumin levels are 10.4 g/dL and 3.37 g/dL. Adequacy of dialysis, measured by Kt/V and URR, showed that 28% of patients had inadequate Kt/V (<1.2), and 34% had inadequate URR (< 65%). The association between Kt/V and URR was significant, indicating that patients with lower URR were more likely to have inadequate dialysis. Higher Kt/V values correlated with better energy fatigue and general health scores. Hemoglobin levels and Albumin levels were significantly associated with social functioning scores, suggesting the better outcome in patients with higher hemoglobin levels and higher albumin levels. Conclusion: This study demonstrates that adequate HD, as measured by Kt/V and URR values, significantly impacts the QOL of CKD patients, particularly in terms of physical functioning, energy/fatigue, general health, and social functioning. Effective management of anemia and nutritional status further enhances these outcomes.