Quality of life and biochemical changes in patients undergoing kidney replacement therapy among patients with end-stage kidney disease: a cross-sectional study from Brunei Darussalam.

BACKGROUND

End-stage kidney disease (ESKD) requires lifelong kidney replacement therapy (KRT), which significantly influences patients' quality of life (QoL). Primary KRT modalities include hemodialysis (HD), peritoneal dialysis (PD), and kidney transplant (KTX), each with varying impacts on QoL and clinical outcomes. Comparative data regarding these modalities in the local context, is limited.

OBJECTIVES

This study aims to evaluate and compare the QoL and biochemical profiles of patients undergoing different KRT modalities in Brunei Darussalam.

METHODS

A cross-sectional study was conducted in 2024 among 574 patients receiving HD, PD, or KTX across all government dialysis centers in Brunei. QoL was assessed using the validated SF-12 questionnaire, and biochemical parameters were collected from Brunei Darussalam Healthcare Information and Management System (BruHIMS). Sociodemographic and clinical data were used to profile and subgroups analysis.

RESULTS

KTX patients reported the highest QoL scores and most favorable biochemical profiles, reinforcing transplantation as the optimal modality when available. Among dialysis patients, PD was associated with higher physical health scores than HD, suggesting better QoL. KTX patients were generally younger, with higher educational and employment levels. Significant differences in biochemical parameters such as hemoglobin, albumin, creatinine, urea, phosphate, and cholesterol were observed across modalities, indicating modality-specific clinical impacts.

CONCLUSION

The findings suggest that PD may be associated with slightly better QoL outcomes compared to HD. However, these differences were not statistically significant and should be interpreted with caution, particularly given the potential for residual confounding inherent in observational study designs. Future research should focus on examining the long-term QoL trajectories among PD patients and identifying strategies to optimize its clinical benefits in the management of ESKD in Brunei.