HEALTH-RELATED QUALITY OF LIFE AND PSYCHOSOCIAL ADAPTATION IN PATIENTS WITH END-STAGE RENAL DISEASE UNDERGOING MAINTENANCE HEMODIALYSIS

Chronic kidney disease represents a progressive and irreversible decline in renal function that ultimately culminates in end-stage renal disease, a life-threatening condition characterized by the near-complete loss of glomerular filtration capacity. At this advanced stage, renal replacement therapy becomes essential for survival. Among available modalities, maintenance hemodialysis remains the most widely utilized treatment worldwide. Over the past decades, technological improvements in dialysis membranes, vascular access management, and supportive pharmacotherapy have substantially extended life expectancy in patients with end-stage renal disease. Survival gains of ten years or more are no longer uncommon in well-managed populations. However, increased longevity has not been uniformly accompanied by proportional improvements in quality of life. Instead, many individuals experience profound physical limitations, psychological distress, and social disruption as a direct or indirect consequence of long-term dialysis dependence.