Nearly 2 million people reach end-stage kidney failure each year in India, and in the last two decades, mortality due to kidney failure has doubled. This study aims to assess the quality of life of hemodialysis patients and its relationship to demographic and laboratory parameters, and to determine if there are any differences among patients undergoing dialysis sessions at different times during the day.

This was a cross-sectional, single-center study to assess hemodialysis patients’ overall quality of life, the differences, if any, of different timing of dialysis sessions, and the factors affecting it. We used structural equation modeling for multivariable analysis, while Chi-square minimum and root mean square error of approximation were used as model fit indices. QOL of hemodialysis patients was assessed using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire across four dimensions: physical, psychological, social, and environmental health. Out of 142 patients on dialysis at our center during the study period, we excluded 12 patients receiving thrice-weekly dialysis, and 14 who did not meet inclusion criteria. Thus, 116 patients were selected for data collection.

The quality of life of hemodialysis patients on twice weekly hemodialysis was poor. There was no difference between the timing of dialysis session during the day. Education, employment status, and financial income were associated with quality of life. While family income was statistically significant in all four domains, educational level was related to psychological and environmental domains, and employment status was correlated with physical health and social relationships.

Family income, employment status, and education were the most critical factors affecting the quality of life of hemodialysis patients undergoing twice-weekly dialysis in a resource-limited setting. Encouraging hemodialysis patients to continue working whenever feasible, giving them the opportunity to adjust for their physical capacity, and receiving help from other family members can improve family income, thus increasing the quality of life of these chronically ill and often neglected patients.