Abstract / Summary
Abstract Background Treatment burden in chronic hemodialysis (HD) requires the use of patient-centered outcomes like Quality of Life (QOL). This study investigated the association of treatment satisfaction with QOL and all-cause mortality in maintenance HD patients. Methods This was a prospective observational cohort study of 346 chronic HD patients. Patients were classified into Satisfied (score ≥ 66.7, n = 241) and Not Satisfied (score < 66.7, n = 105) groups based on the Kidney Disease Quality of Life-Short Form (KDQOL-SF™). The association of satisfaction with QOL was analyzed by linear regression, and with all-cause mortality by Kaplan-Meier and multivariable Cox proportional hazards models. Results The Not Satisfied Group showed a significantly higher prevalence of diabetes mellitus (DM) (49.5% vs. 38.6%, p = 0.044) and cardiovascular disease (CVD) (43.8% vs. 32.8%, p = 0.038), along with higher serum C-reactive protein (CRP) and LDL-cholesterol levels. Patients in the Satisfied Group exhibited significantly higher scores across all domains of both SF-36 and KDQOL (all p < 0.05). However, Kaplan-Meier analysis showed no significant difference in cumulative survival (Log-rank test: p = 0.838). In multivariable Cox analysis, treatment satisfaction was not an independent predictor of all-cause mortality. Conclusions Treatment satisfaction is significantly and positively associated with comprehensive QOL domains in HD patients, but it is not a direct, independent predictor of all-cause mortality. These findings suggest that satisfaction reflects psychosocial well-being distinct from the objective physiological factors driving long-term survival.