Factors Associated with the Quality of Life in End-Stage Renal Disease Patients Undergoing Hemodialysis

Background: The quality of care for patients undergoing hemodialysis continues to improve, and various parameters can be used to predict mortality. As the life expectancy of these patients has increased, increasing attention has been paid to their quality of life. In this study, we used the 36-Item Short Form Health Survey (SF-36) as a surrogate of quality of life to investigate associations between hemodialysis parameters and quality of life. Methods: We conducted a cross-sectional study to evaluate associations among comorbidities, nutritional, inflammatory, and fluid-control status, and SF-36 in hemodialysis patients. Results: In multiple linear regression analysis, physical component summary (PCS) was independently significantly associated with hemoglobin (standardized coefficient, 0.259; P = 0.015) and cardiothoracic ratio (CTR) (standardized coefficient, -0.271; P = 0.007). The mental component summary was independently significantly associated with serum albumin level (standardized coefficient, 0.251; P ＜ 0.001). In the subgroup analysis of PCS, physical functioning was independently significantly associated with age (standardized coefficient, -0.282; P = 0.002), CTR (standardized coefficient, -0.333; P ＜ 0.001), diabetes mellitus (standardized coefficient, -0.24; P = 0.009), and C-reactive protein (standardized coefficient, -0.197; P = 0.023). In addition, role limitation due to physical problems was independently significantly associated with serum albumin level (standardized coefficient, 0.375; P = 0.001), and bodily pain and general health were independently significantly associated with hemoglobin level (standardized coefficient: 0.169, 0.356, P = 0.02, 0.002). Receiver operating characteristic curve analysis showed an optimal CTR cut-off value of 0.475, with a sensitivity of 66.7%, specificity of 65.7%, and area under the curve of 0.727 to predict which patients would have a good health-related quality of life performance. Conclusion: In the hemodialysis patients enrolled in this study, a better PCS score was associated with adequate fluid status control and better hemoglobin level. In addition, a better mental component summary score was associated with better nutritional status.