THE IMPORTANCE OF QUALITY-OF-LIFE ASSESSMENT IN THE CARE AND MANAGEMENT OF HEMODIALYSIS PATIENTS

Introduction: Hemodialysis is a vital treatment for patients with stage 5 chronic kidney disease. However, it requires long-term treatment and can substantially affect daily life. Treatment outcomes have traditionally been assessed mainly through clinical and laboratory measures, such as dialysis adequacy and hemoglobin and electrolyte levels. Health-related quality of life (HRQoL) is also an important measure of treatment outcomes. Aim: To examine the importance of quality-of-life assessment in the care and management of patients receiving hemodialysis. Methods: The scientific literature on quality-of-life assessment in hemodialysis patients was reviewed. The Missoula-VITAS Quality of Life Index (MVQOLI), which assesses five domains—symptoms, functional status, interpersonal relationships, well-being, and transcendence—is described. Other commonly used instruments, including the SF-36 and KDQOL-SF, are also considered, together with demographic, clinical, and psychosocial factors associated with patients’ quality of life. Results: The literature indicates that quality of life is often reduced among patients receiving hemodialysis, particularly in physical functioning, vitality, and emotional well-being. Factors associated with quality of life include age, comorbidities such as diabetes and cardiovascular disease; anemia; nutritional status; chronic pain and pruritus; sleep disturbances; depression and anxiety; social support; employment opportunities; and the day-to-day restrictions associated with dialysis. Poorer quality of life may be associated with a higher risk of hospitalization and mortality, as well as difficulties following the prescribed treatment regimen. Conclusion: Regular assessment of quality of life can identify problems that may not be apparent from clinical and laboratory measures alone. It can support individualized care, the early recognition of psychosocial difficulties, and patients’ active participation in decision-making. Quality-of-life assessment should therefore be part of quality management in hemodialysis services and guide the multidisciplinary team in planning patient care, including nephrologists, nurses, psychologists, nutritionists, and other specialists.