#5243 ASSESSING HEALTH-RELATED QUALITY OF LIFE IN HEMODIALYSIS PATIENTS IN A PUBLIC HOSPITAL IN TUNIS: A CROSS-SECTIONAL STUDY

Abstract

Abstract Background and Aims There are not many studies evaluating the quality of life of patients with chronic and advanced kidney disease in North Africa. We assessed the health-related quality of life (HRQOL) of patients receiving hemodialysis in a public hospital in Tunis using the KDQOLTM-36 (Kidney Disease Quality of Life) survey, and we investigated its sociodemographic, clinical and biological correlation. Method A cross-sectional study design was used, and patients were recruited from a single hemodialysis center in the Charles Nicolle Hospital in Tunis. The KDQOLTM-36 questionnaire was given to patients aged 18 or above receiving in-center hemodialysis maintenance for at least three months to assess their physical and mental health, as well as the effect, burden, and symptoms of kidney disease. Patients with hepatitis, HIV, mental illnesses, and physical disabilities were not eligible for the study. Socio-demographic and clinical data were collected for all eligible patients. We then employed linear regression models to explore the factors associated with overall KDQOL and its various domains. Results Sixty-five patients were included. The mean age was 50.9 years old (23-79). The sex ratio was 1.16. The median quality of life score was 52.5 for overall HRQOL, 35,6 for the Physical Component Summary (PCS) score and 44.2 for the Mental Component Summary (MSC) score. Symptoms/problems, effect, and burden of kidney disease (KD) were scored 62.5, 59.38 and 37.5, respectively. There was a significant correlation between diabetic and non-diabetic patients in Symptoms (50.19 vs 65.04 p = 0.006), Effect (45.4 vs 57.87 p = 0.038), Burden of KD (7.38 vs 39.46 p = 0,001) and MCS (p<0,0001). Cardiovascular disease was associated with a higher burden of KD (p = 0.025). Higher age was associated with lower score in Symptoms (p = 0.032) and Burden (p = 0.035). Other correlations were between weight gain between sessions and MCS (p = 0.012), Hyponatremia with both symptoms (p = 0.016), effect (p = 0.029) and MCS (p = 0.017), Hypoalbuminemia with symptoms (p = 0.018), dilated left cavity in the transthoracic ultrasound with both effect(p = 0.047) and burden of KD (p = 0.023). There was no correlation found between gender, work status and hemoglobin level and quality of life. Conclusion The results of this study indicate that patients receiving hemodialysis have a low quality of life. The factors associated with overall quality of life were diabetes, cardiovascular disease, age, weight gain between dialysis sessions, hyponatremia, hypoalbuminemia, and dilated left cavity in transthoracic ultrasound. Those findings should be studied using a larger sample.