ASSESSING THE IMPACT OF RESIDUAL KIDNEY FUNCTION ON QUALITY OF LIFE IN HEMODIALYSIS PATIENTS AUTHORS LIST

Abstract

Background: Residual kidney function (RKF) is a crucial factor in hemodialysis patients, potentially influencing clinical outcomes and health-related quality of life (HRQOL). This study aimed to assess the impact of RKF on the quality of life (QoL) and hospitalization rates in patients undergoing hemodialysis.

Methods: A prospective observational cohort study was conducted over six months with 150 hemodialysis patients. Participants were categorized into two groups based on baseline renal Kt/V urea: significant RKF (Kt/V ≥ 1.0/week, n=68) and low/no RKF (Kt/V < 1.0/week, n=74). The primary outcome, QoL, was measured using the KDQOL-36™ questionnaire at baseline, three months, and six months. A Linear Mixed-Effects Model, adjusted for age and serum albumin, was used to analyze longitudinal changes in QoL scores. The association between RKF and hospitalization was analyzed using a negative binomial regression model.

Results: Patients with significant RKF had significantly higher physical (PCS) and mental (MCS) component summary scores at all time points compared to the low/no RKF group. QoL scores remained stable over six months in the significant RKF group but declined significantly in the low/no RKF group (p<0.05 for group and time effects). A positive correlation was found between continuous RKF values and both PCS (r=0.32, p<0.001) and MCS (r=0.28, p=0.001) scores. Furthermore, the significant RKF group had a 41% lower rate of hospitalization compared to the low/no RKF group (Adjusted IRR = 0.59, 95% CI: 0.42-0.83, p=0.002).

Conclusion: The preservation of residual kidney function is strongly associated with better and more stable quality of life, both physically and mentally, and a significantly lower hospitalization rate in hemodialysis patients. Clinical strategies aimed at preserving RKF should be prioritized to improve patient-centered outcomes.