Dialysis Efficacy in End-Stage Renal Disease: The Interplay of Obesity, Age, Dialysis Duration, and Psychological Disturbance — A Correlational Cross-Sectional Study

Abstract

Background: Dialysis efficacy is a critical determinant of survival and quality of life in patients with end-stage renal disease (ESRD). However, multiple patient-related factors—such as obesity, age, duration of dialysis, and psychological disturbance—may influence treatment outcomes. Understanding the interplay between these factors and dialysis effectiveness can help inform more personalized and holistic care strategies. Objective: To investigate the relationship between dialysis efficacy and four key variables: obesity, age, dialysis duration, and psychological disturbance in patients undergoing maintenance hemodialysis. Methods: A cross-sectional study was conducted among adult ESRD patients receiving regular hemodialysis. Dialysis efficacy was measured using Kt/V and urea reduction ratio (URR). Obesity was assessed by body mass index (BMI). Psychological disturbance was evaluated using validated scales including the Perceived Stress Scale (PSS-10). Correlation and multivariate regression analyses were performed to examine the association between the studied variables and dialysis efficacy. Results: All significant predictors of dialysis efficacy (age, duration of dialysis, and psychological stress) identified at univariate analysis were entered a multivariate linear regression model together. This analysis identified that only duration of dialysis is a significant predictor. Conclusions: Patient-specific characteristics (age, BMI, duration of dialysis, and psychological stress) can play an effect on dialysis adequacy especially duration of dialysis. Ongoing research is needed to delineate further effect of patient-specific characteristics on dialysis adequacy.