Researchers studied 260 people in Nepal who receive dialysis treatment for kidney disease to understand what affects their quality of life. They found that patients struggle with more than just physical symptoms like tiredness and pain—they also face serious emotional challenges, money problems, and loss of independence. The study shows that money and access to mental health support matter just as much as medical treatment. By listening to patients’ real experiences, doctors can better understand how to help them live better lives while managing their kidney disease.

The Quick Take

  • What they studied: How kidney dialysis patients in Nepal experience their daily lives and what factors make their situation harder or easier
  • Who participated: 260 adults receiving dialysis treatment at a major kidney center in Kathmandu, Nepal. Most were men (64%), married, and had advanced kidney disease. Researchers also interviewed 15 patients in depth to hear their personal stories
  • Key finding: Three-quarters of patients reported heavy treatment burden. Beyond physical symptoms, emotional problems like anxiety and depression were very common, especially for those with money problems. Financial stress and lack of mental health support were just as important as medical issues
  • What it means for you: If you or someone you know has kidney disease requiring dialysis, this research suggests that getting help for emotional health and financial stress is just as important as medical treatment. Healthcare providers should pay attention to mental health and practical life challenges, not just physical symptoms

The Research Details

This study used a mixed-method approach, meaning researchers collected both numbers (from surveys) and personal stories (from interviews). They gave 260 patients a detailed survey about their physical health, emotional well-being, and daily life while they were receiving dialysis treatment. At the same time, they interviewed 15 patients one-on-one to hear about their personal experiences living with kidney disease. The researchers used a special survey tool called KDQOL-36 that was translated into Nepali so patients could answer in their own language. They analyzed the survey answers using statistics and organized the interview stories into themes to find patterns in what patients experienced.

By combining numbers with personal stories, researchers get a complete picture of what patients actually go through. Numbers alone can’t capture the emotional pain or financial stress, and stories alone can’t show how common these problems are. This mixed approach helps doctors understand that kidney disease affects patients in many ways beyond just the physical body

This study is reliable because it was conducted at a major kidney center with a large group of patients (260), used validated survey tools designed specifically for kidney patients, got approval from an ethics board to protect patient rights, and combined both measurable data and detailed patient experiences. The researchers were careful to protect patient privacy and got permission from everyone who participated

What the Results Show

The study found that 74% of dialysis patients reported significant treatment burden—meaning dialysis takes a heavy toll on their lives. Patients experienced common physical symptoms including extreme tiredness, weight loss, pain, and difficulty moving around. These physical problems often led to dependency on family members and loss of independence, which caused emotional distress. Mental health problems were very common, with many patients experiencing anxiety, depression, and worry about their future. Importantly, financial strain was strongly connected to how severe symptoms were and how much patients struggled emotionally. Patients with less money reported worse physical symptoms and more emotional problems. Family support and having good coping strategies helped some patients feel more resilient and better able to handle their situation.

The research found that men reported higher treatment burden than women, and patients with less education reported more difficulties. Interestingly, how long someone had been on dialysis, their marital status, and their diet did not significantly affect their quality of life scores. This suggests that personal factors like money and education matter more than disease duration. Patients emphasized that losing their ability to work and be independent was one of the most emotionally painful parts of their experience

This research confirms what other studies have shown—that kidney disease affects people’s emotional and social lives as much as their physical health. However, this study is important because it specifically looks at patients in Nepal, where access to mental health support and financial resources is limited. It shows that the emotional and financial burdens may be even greater in countries with fewer healthcare resources. The findings align with global research showing that quality of life for dialysis patients depends on much more than just medical treatment

This study only looked at patients at one major kidney center in Kathmandu, so results may not apply to patients in rural areas or other parts of Nepal with different healthcare systems. The study included more men than women, so we don’t know if women’s experiences might be different. Because this was not an experiment comparing different treatments, we can’t say that money problems definitely cause worse symptoms—only that they’re connected. The study was done at one point in time, so we don’t know how patients’ experiences change over months or years

The Bottom Line

Healthcare providers should screen dialysis patients for depression and anxiety and provide mental health support as part of regular care. Patients and families should seek financial counseling and assistance programs to reduce money stress. Community support groups and peer support programs appear helpful for emotional well-being. Decentralized dialysis centers (closer to patients’ homes) could reduce travel burden. These recommendations are supported by this research but should be combined with guidance from your own healthcare team (moderate confidence level)

This research is most relevant for people with kidney disease requiring dialysis, their families, kidney doctors and nurses, hospital administrators in Nepal and similar countries, and policymakers making healthcare decisions. If you have early-stage kidney disease, this shows why managing it well now is important. If you’re a caregiver for someone on dialysis, this explains why emotional support matters as much as medical care

Improvements in emotional well-being from mental health support might be noticed within weeks to months. Financial relief from assistance programs could reduce stress relatively quickly. Physical symptom improvement depends on dialysis effectiveness and overall health management. Long-term quality of life improvements require ongoing support across medical, emotional, and financial areas

Want to Apply This Research?

  • Track weekly mood scores (1-10 scale), energy levels, and emotional challenges alongside dialysis session information. Note which days or situations trigger anxiety or depression to identify patterns and helpful coping strategies
  • Use the app to connect with support resources: set reminders for mental health check-ins, log financial stressors to discuss with a counselor, track family support activities, and record coping strategies that help. Share mood and symptom trends with your healthcare team during appointments
  • Monitor emotional well-being alongside physical symptoms monthly. Track whether mental health support or financial assistance programs are helping. Note changes in independence level and daily activities. Share this holistic picture with your care team to ensure treatment addresses all aspects of quality of life, not just physical health

This research describes experiences of kidney dialysis patients in Nepal and should not be used to diagnose or treat any medical condition. If you have kidney disease or are on dialysis, work with your nephrologist (kidney specialist) and healthcare team for personalized medical advice. Mental health support should be provided by qualified mental health professionals. This study provides insights into patient experiences but does not replace professional medical evaluation and treatment. Always consult your doctor before making changes to your dialysis treatment or care plan.