ArticleBMJ open2025
Impact of mental health status and clinical factors on health-related quality of life in patients undergoing haemodialysis: a multicentre cross-sectional study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Beyond Dialysis Adequacy: Transportation Time and Pain as Quality-of-Life Predictors in Polish Hemodialysis Patients-A Single-Center Study.Journal of clinical medicine · 2026Article
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6 authors.
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Abstract
objectivesThis study aimed to investigate the factors influencing health-related quality of life (HRQoL) in patients undergoing haemodialysis, focusing on the association between HRQoL dimensions and sociodemographic variables, clinical parameters, mental health status and biochemical indicators.
designA multicentre cross-sectional study conducted over 30 months.
settingThe study was carried out in secondary care centres across multiple locations in the Community of Extremadura, Spain.
participantsA total of 150 patients undergoing haemodialysis were recruited between March 2022 and September 2023. Inclusion criteria required patients to be diagnosed with chronic kidney disease (CKD) and undergoing haemodialysis. Patients unable to provide informed consent or with severe cognitive impairment were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES: HRQoL was assessed using the Kidney Disease Quality of Life 36-item Short Form scale. Mental health parameters, specifically anxiety and depression, were evaluated using the Hospital Anxiety and Depression Scale. Biochemical markers such as haemoglobin and haematocrit levels, as well as sociodemographic and clinical data, were analysed for their influence on HRQoL.
resultsSymptoms of anxiety and depression were prevalent among patients undergoing haemodialysis. Anxiety had the greatest negative effect on HRQoL, being significantly associated with lower scores in the mental component summary (MCS) (β = -2.06; 95% CI -2.78 to -1.33; R² = 0.106; p<0.001) and CKD-specific symptoms/problems (β = -1.31; 95% CI -1.74 to -0.88; R² = 0.121; p<0.001). Depression also negatively influenced MCS (β = -3.04; 95% CI -3.87 to -2.78; R² = 0.270; p<0.001). Increasing age was inversely associated with HRQoL across several dimensions, particularly burden of kidney disease (β = -0.74; 95% CI -1.07 to -0.40; R² = 0.112; p<0.001) and MCS (β = -0.76; 95% CI -1.05 to -0.46; R² = 0.148; p<0.001). Longer disease duration was positively correlated with MCS (β=0.38; 95% CI 0.06 to 0.70; R² = 0.036; p=0.020), while longer time on haemodialysis correlated positively with symptoms/problems (β=0.85; 95% CI 0.53 to 1.17; R² = 0.096; p<0.001) and both PCS and MCS (β=1.36; 95% CI 0.85 to 1.87; R² = 0.095; p<0.001; β=1.10; 95% CI 0.56 to 1.64; R² = 0.057; p=0.012, respectively). Regarding biochemical parameters, higher haemoglobin (β=3.45; 95% CI 1.00 to 5.90; R² = 0.050; p=0.006) and haematocrit (β=1.37; 95% CI 0.46 to 2.28; R² = 0.057; p=0.003) were significantly associated with reduced burden of kidney disease, indicating better HRQoL.
conclusionsDepression and anxiety, along with older age, were identified as key factors negatively affecting HRQoL of patients undergoing haemodialysis. Management of mental health, alongside optimisation of clinical care to minimise complications, could enhance the HRQoL in this patient population. Further research is recommended to develop targeted interventions addressing anxiety and other modifiable factors influencing HRQoL in haemodialysis patients.
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