Health Related Quality of Life (HRQOL) of Patients With End Stage Kidney Disease (ESKD) on Hemodialysis in Addis Ababa, Ethiopia: A Cross-Sectional Study

Abstract Background: Patients with End-Stage Kidney Disease (ESKD) depend on hemodialysis as a lifesaving treatment for the remainder of their lives. However, the health related quality of life (HRQOL) of patients on hemodialysis is much more underappreciated in resource limited countries, since the hemodialysis is mostly unaffordable or unavailable. Methods: A hospital based cross-sectional study was conducted in Addis Ababa, Ethiopia, from August 01 to October 31, 2019. All patients (n = 125) who were on hemodialysis in five selected public and private hospitals were included in the study. Data were administered by trained nurses by using a standardized Kidney Disease Quality of Life (KDQOL™-36) questionnaire. Clinical data were extracted from the patients’ medical charts. HRQOL was categorized as low, if the overall mean score was ≤50, or as high, if the overall mean score was >50. Factors associated with lower HRQOL were identified by Multi-variable binary logistic regression analysis and expressed by adjusted odds ratio (aOR). Results: The mean age of the study participants was 50.33 years (±15.07) and more than two-thirds (68.8%) of the patients were males. The mean score of HRQOL was 49.08±11.09, with 45.4% of them had lower HRQOL. In the multi-variable model, unemployed patients (aOR = 2.40, 95% CI: 1.10 – 5.90; p-value = 0.03) and patients who had hemodialysis 2 times per week (aOR = 1.71, 95% CI: 1.07 – 3.83; p-value = 0.04) were associated with lower HRQOL. In the further sub-group analysis, elderly patients had higher odds of having lower mean score on the burden of kidney disease (BKD) (aOR = 2.07; 95% CI 1.18 – 4.13; p-value = 0.02) as compared to the younger patients.Conclusions: A substantial proportion of the patients with ESKD on hemodialysis in Addis Ababa had lower overall HRQOL which is associated with their unemployment status and frequency of hemodialysis per week. Therefore, not only the clinical treatment but also quality of life of patients with chronic dialysis should be given special attentions during the patients’ care.