• Aras Hama Saeed Faraj Ministry of Health, Kurdistan Region, Iraq.
  • Dana Ahmed Sharif College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.



Quality of life (QOL), Hemodialysis (HD), End-Stage Renal Disease (ESRD), Health-Related QOL (HRQOL)


Quality of life is an important parameter that needs to be considered when evaluating the outcome of patients
receiving healthcare; this is especially the case for patients with long-term chronic diseases. Furthermore, with
the increasing medical ability to prolong life, the patient’s quality of life has become an increasingly legitimate
medical outcome. Therefore, assessment of patients’ quality of life not only helps assess the quality of the
dialysis but also is useful to guide nephrologists to develop better interventions and plans of care for the future.

To assess the quality of life and factors affecting hemodialysis patients.

Patients and Methods
An observational, cross-sectional study was conducted among (209) patients on maintenance hemodialysis
at six major hemodialysis centres in Sulaimani Governorate. They are using a questionnaire face-to-face
interview for ten months, from 7/Sep./2021 to 10/Jun/2022. Data analysis by the IBM SPSS program,
quantitative variables are expressed as mean ± standard deviation (M±SD), median and interquartile, and
results from qualitative variables are expressed as percentages. P-value < 0.05 assume the significance for

Overall mean quality of life was near (37%) in (100%) of normal persons, with an SD (of 13.26). Over one-third
were in the age group of (50-64) years, and the number increased by age. Nearly equal male-to-female ratio
(50.2male, while 49.8 female). (46.4%) were illiterates, and (67%) were Unemployed. Claimed that they had no
income (65.6 %) and diabetes mellitus among patients (45.9%). Demographic factors, dialysis adequacy, and
clinical factors are among the factors that affect the quality of life.

Despite regular hemodialysis, the patient’s quality of life on maintenance hemodialysis is severely affected.
Both clinical and nonclinical factors, such as demographic factors, Dialysis adequacy, comorbidities, and
others, were severely affecting the quality of life of patients on maintenance hemodialysis, especially physical


Joshi U, Subedi R, Poudel P, Ghimire PR, Panta S, Sigdel MR. Assessment of quality of life in patients undergoing hemodialysis using WHOQOL-BREF questionnaire: A multicenter study. International Journal of Nephrology and Renovascular Disease. 2017 Jul 19; 10:195–203. DOI:

Thenmozhi P. Quality of life of patients undergoing hemodialysis. Asian Journal of Pharmaceutical and Clinical Research. 2018 Apr 1;11(4):219–23. DOI:

Claire Mukakarangwa M. Chironda G,Nkurunziza A,. Ngendahayo F, Bhengu B, Motivators and Barriers of adherence to hemodialysis among patients with End Stage Renal Disease (ESRD) in Rwanda: A qualitative study, International Journal of Africa Nursing Sciences (2020), doi: 10.1016/j.ijans.2020.100221 DOI:

Rak A, Raina R, Suh TT, Krishnappa V, Darusz J, Sidoti CW, Gupta M. Palliative care for patients with end-stage renal disease: approach to treatment that aims to improve quality of life and relieve suffering for patients (and families) with chronic illnesses. Clin Kidney J. 2017 Feb;10(1):68-73. doi: 10.1093/ckj/sfw105. Epub 2016 Dec 16. PMID: 28638606; PMCID: PMC5469574.

Yousif Yahya Hassan B. Járomi, M., Szilágyi, B., Velényi, A. Assessment of health-related quality of life and patient’s knowledge in chronic non-specific low back pain. BMC Public Health 21, 1479 (2021). Research theses [Internet]. 2017;156(1). Available from: DOI:

Phillips RL. Quality of Life Among Hemodialysis Patients: Evaluating the Kdqol-36 and Its Utility in Clinical Practice (Doctoral dissertation, University of Georgia). the Graduate Faculty of The University of Georgia the Degree DOCTOR OF PHILOSOPHY ATHENS, GEORGIA 2017 Original theses 2017.

World Health Organization. WHOQOL-BREF: introduction, administration, scoring and generic version of the assessment: field trial version, December 1996. World Health Organization; 1996.

Wong FY, Yang L, Yuen JWM, Chang KKP, Wong FKY. Assessing quality of life using WHOQOL-BREF: a cross-sectional study on the association between quality of life and neighborhood environmental satisfaction, and the mediating effect of health-related behaviors. BMC Public Health. 2018 Sep 12;18(1):1113. doi: 10.1186/s12889-018-5942-3. PMID: 30208869; PMCID: PMC6134517. DOI:

Hussien H, Apetrii M, Covic A. Health-related quality of life in patients with chronic kidney disease. Vol. 21, Expert Review of Pharmacoeconomics and Outcomes Research. Taylor and Francis Ltd.; 2021. p. 43–54. DOI:

Walters BAJ, Hays RD, Spritzer KL, Fridman M, Carter WB. Health-related quality of life, depressive symptoms, anemia, and malnutrition at hemodialysis initiation. American Journal of Kidney Diseases. 2002 Dec 1;40(6):1185–94. DOI:

Hasan LM, Shaheen DA, El Kannishy GA, Sayed-Ahmed NA, Abd El Wahab AM. Is health-related quality of life associated with adequacy of hemodialysis in chronic kidney disease patients. BMC nephrology. 2021 Dec;22(1):1-2. DOI:

Germin-Petrović D, Mesaros-Devcić I, Lesac A, Mandić M, Soldatić M, Vezmar D, Petrić D, Vujicić B, Basić-Jukić N, Racki S. Health-related quality of life in the patients on maintenance hemodialysis: the analysis of demographic and clinical factors. Coll Antropol. 2011 Sep;35(3):687-93. PMID: 22053542.

Cohen, D.E., Lee, A., Sibbel, S. se of the KDQOL-36™ for assessment of health-related quality of life among dialysis patients in the United States. BMC Nephrol 20, 112 (2019). DOI:

Mingardi G, Cornalba L, Cortinovis E, Ruggiata R, Mosconi P, Apolone G. Health-related quality of life in dialysis patients. A report from an Italian study using the SF-36 Health Survey. DIA-QOL Group. Nephrol Dial Transplant. 1999 Jun;14(6):1503-10. doi: 10.1093/ndt/14.6.1503. PMID: 10383015. DOI:

Anees m., Hameed f., Mumtaz a., Ibrahim m., Saeed khan. dialysis-related factors affecting quality of life in patients on hemodialysis. iranian journal of kidney diseases (ijkd). 2011 [cited 2022august10];5(1):9-14.

Hagerty, M.R., Cummins, R.A., Ferriss, A.L. Quality of Life Indexes for National Policy: Review and Agenda for Research. Social Indicators Research 55, 1–96 (2001). DOI:

Dana A Sharif, Alaa H Awn, Kosar M Murad, Ibrahim M A Meran. Demographic and Characteristic Distribution of End Stage Renal Failure in Sulaimani Governorate, Kurdistan Region, Iraq. Int J Med Res Prof. 2017; 3(1):155-58. DOI:10.21276/ijmrp.2017.3.1.037

Ayoub AM, Hijjazi KH. Quality of life in dialysis patients from the United Arab Emirates. J Family Community Med. 2013 May;20(2):106-12. doi: 10.4103/2230-8229.114772. PMID: 23983562; PMCID: PMC3748644. DOI:

Chan CT, Blankestijn PJ, Dember LM, Gallieni M, Harris DCH, Lok CE, et al. Dialysis initiation, modality choice, access, and prescription: conclusions from a kidney disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney International. 2019 Jul 1;96(1):37–47.

Doan KVD, Nguyen HTM, Nguyen NTH, Dang KC, Yang SH, van Duong T. Associations of socio-demographic, clinical and biochemical parameters with healthcare cost, health-and renal-related quality of life in hemodialysis patients: A clinical observational study. International Journal of Environmental Research and Public Health. 2020 Sep 2;17(18):1–15. DOI:

Ali AA, Almukhtar SE, Abd KH, Saleem ZS, Sharif DA, Hughson MD. The causes and frequency of kidney allograft failure in a low-resource setting: observational data from Iraqi Kurdistan. BMC nephrology. 2021 Dec;22(1):1-3. DOI:

Yang F, Wong CKH, Luo N, Piercy J, Moon R, Jackson J. Mapping the kidney disease quality of life 36-item short form survey (KDQOL-36) to the EQ-5D-3L and the EQ-5D-5L in patients undergoing dialysis. European Journal of Health Economics. 2019 Nov 1;20(8):1195–206. DOI:

Mollaoğlu, M. Quality of Life in Patients Undergoing Hemodialysis. In: Suzuki, H. , editor. Hemodialysis [Internet]. London: IntechOpen; 2013 [cited 2022 Aug 09]. Available from: doi: 10.5772/52277 DOI:

Dana & Amin, Salar & Hamid, Deler. (2019). LEFT VENTRICULAR HYPERTROPHY IN CHRONIC KIDNEY DISEASE IN SULAIMANI CITY. Journal of Sulaimani Medical College. 9. 97-109. 10.17656/jsmc.10195. DOI:

Breiterman-White, Randee. (2005). Functional ability of patients on dialysis: the critical role of anemia. Nephrology nursing journal: journal of the American Nephrology Nurses’ Association. 32. 79-82.

Hsieh RL, Huang HY, Chen SC, Lin WH, Wu CW, Chang CH, Lee WC. Changes in physical functional performance and quality of life in hemodialysis patients in Taiwan: a preliminary study. J Nephrol. 2010 Jan-Feb;23(1):41-8. PMID: 20091485.

Bohlke M, Nunes DL, Marini SS, Kitamura C, Andrade M, Von-Gysel MP. Predictors of quality of life among patients on dialysis in southern Brazil. Sao Paulo Med J. 2008 Sep;126(5):252-6. doi: 10.1590/s1516-31802008000500002. PMID: 19099157. DOI:

Twardowski ZJ. Short, thrice-weekly hemodialysis is inadequate regardless of small molecule clearance. The International Journal of Artificial Organs. 2004 Jun;27(6):452-66. DOI:

Heidenheim AP, Muirhead N, Moist L, Lindsay RM. Patient quality of life on quotidian hemodialysis. American Journal of Kidney Diseases. 2003 Jul 1; 42:36-41. DOI:

FHN Trial Group. In-center hemodialysis six times per week versus three times per week. New England Journal of Medicine. 2010 Dec 9;363(24):2287-300. DOI:



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