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Background <p>End-stage kidney disease (ESKD) remains a growing public health concern in Brunei Darussalam, where the incidence and prevalence of kidney replacement therapy (KRT) are among the highest globally. While dialysis and kidney transplantation (KTX) extend survival, the health-related quality of life (HRQoL) and biochemical outcomes among patients across different modalities remain insufficiently explored. This study examines the interplay between sociodemographic and biochemical factors and their associations with HRQoL among patients undergoing hemodialysis (HD), peritoneal dialysis (PD), or KTX.</p> Methods <p>A cross-sectional study was conducted among 574 adult patients receiving HD, PD, or KTX from government healthcare facilities across Brunei. Data on sociodemographic characteristics, biochemical profiles, and HRQoL were collected between May and September 2024. HRQoL was assessed using the SF-12 questionnaire, generating Physical Health Score (Phs) and Mental Health Score (Mhs). Linear regression analyses were employed to examine factors associated with HRQoL.</p> Results <p>Of the participants, 77% were on HD, 16% on PD, and 7% had functioning KTX. KTX recipients had significantly higher Phs compared to HD patients (β = 6.8, 95% CI: 4.5–9.2, <i>p</i> &lt; 0.001). KTX was also associated with higher Mhs (β = 2.0, 95% CI: −0.24–4.3, <i>p</i> = 0.037); however, the confidence interval included zero, indicating that this finding should be interpreted cautiously. PD patients demonstrated higher Mhs compared to HD patients. Lower Phs was associated with advancing age, unemployment, and recent hospitalization. Higher hemoglobin (HB) and serum albumin levels were positively associated with physical health. Unemployment was also associated with lower Mhs, underscoring the influence of socioeconomic factors on HRQoL.</p> Conclusion <p>KTX is associated with superior physical HRQoL, while the mental health benefits of KTX and PD are modest. Findings underscore the importance of targeted interventions—such as employment support for working-age HD patients, optimized anemia and nutrition management to improve HRQoL in Brunei’s KRT population beyond broad multidisciplinary care alone.</p>

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Health-Related Quality of Life and Its Determinants Among Patients with End-Stage Kidney Disease in Brunei Darussalam: A National Cross-Sectional Linear Regression Model

  • 期刊论文

  • 发表日期：

    2026年4月27日

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  • Al-Amin Jamain,
  • Jackson Tan,
  • Hanif Abdul Rahman

摘要

Background

End-stage kidney disease (ESKD) remains a growing public health concern in Brunei Darussalam, where the incidence and prevalence of kidney replacement therapy (KRT) are among the highest globally. While dialysis and kidney transplantation (KTX) extend survival, the health-related quality of life (HRQoL) and biochemical outcomes among patients across different modalities remain insufficiently explored. This study examines the interplay between sociodemographic and biochemical factors and their associations with HRQoL among patients undergoing hemodialysis (HD), peritoneal dialysis (PD), or KTX.

Methods

A cross-sectional study was conducted among 574 adult patients receiving HD, PD, or KTX from government healthcare facilities across Brunei. Data on sociodemographic characteristics, biochemical profiles, and HRQoL were collected between May and September 2024. HRQoL was assessed using the SF-12 questionnaire, generating Physical Health Score (Phs) and Mental Health Score (Mhs). Linear regression analyses were employed to examine factors associated with HRQoL.

Results

Of the participants, 77% were on HD, 16% on PD, and 7% had functioning KTX. KTX recipients had significantly higher Phs compared to HD patients (β = 6.8, 95% CI: 4.5–9.2, p < 0.001). KTX was also associated with higher Mhs (β = 2.0, 95% CI: −0.24–4.3, p = 0.037); however, the confidence interval included zero, indicating that this finding should be interpreted cautiously. PD patients demonstrated higher Mhs compared to HD patients. Lower Phs was associated with advancing age, unemployment, and recent hospitalization. Higher hemoglobin (HB) and serum albumin levels were positively associated with physical health. Unemployment was also associated with lower Mhs, underscoring the influence of socioeconomic factors on HRQoL.

Conclusion

KTX is associated with superior physical HRQoL, while the mental health benefits of KTX and PD are modest. Findings underscore the importance of targeted interventions—such as employment support for working-age HD patients, optimized anemia and nutrition management to improve HRQoL in Brunei’s KRT population beyond broad multidisciplinary care alone.