India has 1.4 billion people and has had significant economic growth in recent years. Dietary and living habits have undergone a notable change because of globalization and urbanization. This has contributed to the rapid rise in diseases linked to lifestyle, contain heart disease, diabetes, chronic kidney disease (CKD) and hypertension.[6] The prevalence of CKD has now increased globally, with the ESKD patient population growing by 7% annually. CKD is identified as a global burden especially in the Low- or Middle-Income Country (LMIC) because of the inflated cost of treatment, and lack of knowledge about disease prevention. In India, the estimated annual burden of ESKD ranges from 1,650,000 to 2,200,000. Only 10% or fewer of the patients obtain kidney transplantation while others go for Hemodialysis.[7]
Hemodialysis is a procedure that removes fluids and metabolic waste from blood in the same way as normal kidneys would. The procedure uses a specific membrane or filter that allows the blood flow through it. The filter removes excess content of water, toxic substances, and metabolic waste from the blood. The process purifying the blood, protects the body's homeostatic environment, and manages proper blood pressure through maintaining the proper fluid and electrolyte balance. [1, 2, 3]
Kidney diseases are primarily due to high blood pressure and diabetes. Other causes of this disease include genetic disorders, autoimmune diseases, infections, and effects of nephrotoxic substances. Failure of the kidneys may arise gradually over time, or it may occur suddenly (acute) following a serious infection or by accident.[4] CKD is divided into five phases depending on the estimated glomerular filtration rate (eGFR)[47]. Stage 1 is mild kidney disfunction with normal or high eGFR, while Stage 5, also known as End-stage kidney disease (ESKD), represents significant kidney failure requiring transplantation or dialysis. Healthcare professionals define stage 5 kidney disease as ESKD or kidney failure. During this stage, the kidneys will be operating lesser than their normal capacity, necessitating dialysis or a kidney transplant.[5]
Hemodialysis is done around 10 to 12 hours per week, this procedure performs a vital role for sustaining electrolyte balance, blood pressure control, and symptom management associated with kidney failure. Regular hemodialysis is imperative for ESKD patients who are ineligible for or awaiting kidney transplantation.[8]
In recent years, QoL research indicators have become important investigation instruments for evaluating the effectiveness of treatment intervention in chronic diseases. ESKD is one such example of chronic condition that severely lowers a patient's QoL and leaves them with various limitations. Different kidney replacement therapies (RRT) are now available, which has helped ESKD patients live longer and experience fewer symptoms.[9] Long-term hemodialysis therapy can significantly impact a patient's normal life. It requires a substantial time commitment for regular sessions, necessitates dietary restrictions, and may result in fatigue and reduced energy levels. The treatment is time-consuming, costly, and it involves fluid and dietary restrictions. [10, 11]
Hemodialysis has a significant effect on the patient’s and their family’s lifestyle & interferes with their daily activities. Eating habits, employment, holiday lifestyle, sense of conviction, self-worth, social interactions, and the capacity to enjoy life are the main life domains impacted by ESKD and its treatment. These causes have a detrimental effect on the psychological, environmental, physical, and socioeconomic facets of existence, which compromises QoL. [12, 13]
Medical advances in the treatment of people with chronic illnesses, particularly those with ESKD, have resulted in longer survival times for patients and greater tolerance to illness and therapeutic side effects. Considering this, it is crucial for medical professionals to pay great attention to each patient's unique needs for their fitness, health, tranquility, and well-being. This evaluation of the patient's level of treatment, outcome, and health status as well as their outlook on the future are all included in this assessment of Health related QoL (HRQOL). It is necessary to improving communication between patients and providers also benefits with diagnosing problems and prioritizing them [14, 15, 16, 17]
Credibility, dependability, transferability, and confirmability presented by Guba and Lincoln (1994) to explain realistic methods were used for obtaining data rigor. Depression was recognized as a factor lowering the patients' physical and mental capabilities in Roberti's review study [46]. The people chose seclusion due to their lack of drive, interest in life, and concern towards their caretakers. The mean scores of the investigated hemodialysis the pre-test for total health difference improved in the post- and follow-up tests. [42]
The variations in laboratory parameters before and after hemodialysis play a crucial role in assessing the effectiveness of this kidney replacement therapy. Before hemodialysis, patients may exhibit elevated levels of urea, creatinine, phosphorus, and electrolytes, while potentially experiencing reduced levels of calcium, hemoglobin, albumin, and bicarbonate. However, after hemodialysis, these parameters are expected to show improvement or return to more optimal levels. Monitoring variations in laboratory parameters enables healthcare professionals to gauge the adequacy of dialysis, make necessary adjustments to the treatment plan, and assess the overall health status of patients undergoing long-term hemodialysis therapy. [18, 19, 20].