Mental health status and quality of life in patients with end-stage renal disease undergoing maintenance hemodialysis

Ann Palliat Med. 2021 Jun;10(6):6112-6121. doi: 10.21037/apm-20-2211. Epub 2021 May 26.


Background: This study aimed to identify the association of factors and poorer mental health status and examinate the correlation between mental health status and quality of life (QOL) in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis.

Methods: A total of 190 patients were included in this observational, cross-sectional study. Psychological states of ESRD patients undergoing maintenance hemodialysis were evaluated by the Chinese version symptom checklist-90 (SCL-90) and QOL was assessed using the Chinese Version Kidney Disease Quality of Life-Short Form (KDQOL-SF).

Results: A total of 190 patients with a mean age of 61.68 (13.39) years were included in this study. Multiple stepwise linear regression analyses suggested that when controlling for the confounding variables, prealbumin had the significant influence on average positive factors (Coef., -0.647; 95% CI: -1.314, 0.020; P=0.057), somatization (Coef., -1.334; 95% CI: -2.451, -0.217; P=0.020), obsessive-compulsive (Coef., -1.396; 95% CI: -2.255, -0.537; P=0.002), depression (Coef., -1.241; 95% CI: -2.252, -0.229; P=0.017), phobic anxiety (Coef., -2.576; 95% CI: -3.786, -1.367; P<0.001). In the correlation analysis, the score of average positive factors was significantly correlated with the score of the overall health rating (Coef., -0.343; P<0.001), symptom/problem (Coef., -0.337; P<0.001), effects of kidney disease on daily life (Coef., -0.198; P=0.006), burden of kidney disease (Coef., -0.233; P=0.001), cognitive function (Coef., 0.363; P<0.001), quality of social interaction (Coef., 0.292; P<0.001), social support (Coef., 0.237; P=0.001), physical functioning (Coef., -0.339; P<0.001), pain (Coef., 0.362; P<0.001), general health (Coef., -0.332; P<0.001), mental health (Coef., -0.537; P<0.001), social functioning (Coef., 0.202; P=0.005), vitality (Coef., -0.478; P<0.001), respectively.

Conclusions: In our study, prealbumin, type 2 diabetes mellitus, heart rate, educational level, duration of hemodialysis, coronary artery disease, heart failure, marital status, hemoglobin A1C, hemoglobin were significantly associated with poorer mental health status of ESRD patients undergoing maintenance hemodialysis, and patients with poorer psychological states were more significantly associated with decreased QOL. The results may help clinicians to adopt an effective treatment for early interventions, thus improving the QOL in such population.

Keywords: Chinese; Maintenance hemodialysis; psychological states; quality of life (QOL); symptom checklist-90.

Publication types

  • Observational Study

MeSH terms

  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2*
  • Health Status
  • Humans
  • Kidney Failure, Chronic* / therapy
  • Middle Aged
  • Quality of Life
  • Renal Dialysis
  • Surveys and Questionnaires