Comparative Analysis of Quality of Life in End-Stage Renal Disease: Dialysis, Transplant, and Controls

• Kidney transplantation demonstrates significantly superior Health-Related Quality of Life (HRQoL) scores compared to all dialysis modalities. • Innovatively, this study compares ESRD patients against a healthy local control group , providing a more rigorous baseline for sociocultural analysis. • Transplant recipients exhibited higher mental health scores than healthy individuals, suggesting a "gratitude phenomenon" and high psychological resilience. • Hemodialysis was identified as the treatment modality with the greatest negative impact on both physical and mental dimensions. • The findings emphasize the need for individualized care based on Patient-Reported Outcomes (PROs) rather than subjective clinical assessments. End-stage renal disease significantly affects Health-Related Quality of Life (HRQoL), encompassing physical, psychological, and social aspects influenced by individual experiences, beliefs, expectations, and perceptions. To investigate HRQoL among patients undergoing renal replacement therapy (peritoneal dialysis, hemodialysis), kidney transplant recipients, and healthy controls in Colombia. An a nalytical cross-sectional observational study of 174 adult participants was conducted using a pre-designed questionnaire to gather sociodemographic data. HRQoL was assessed using the SF-36 Health Survey, and statistical analysis was performed using STATAand QualityMetric PROCoRE Health Outcomes Scoring Software. This study included 174 participants distributed across four groups, each with distinct sociodemographic characteristics. Dialysis patients generally showed lower SF-36 scores across all subscales than the Colombian population. However, transplant recipients demonstrated higher scores in m ental component summary, g eneral health, v itality, s ocial functioning, r ole-emotional, and m ental health compared to healthy controls. HRQoL scores varied significantly among the four groups and within the three end-stage renal disease groups ( p < 0.001). Physical Health scores were notably lower for dialysis patients t han for transplant recipients and healthy individuals (<50), whereas Mental Health scores were higher for peritoneal dialysis patients, transplant recipients, and healthy controls (≥50). Hemodialysis patients had the greatest impact on their quality of life (≤50). Among the dialysis patients, the physical domain was the most affected. Kidney transplantation showed superior performance in both physical and mental dimensions, surpassing even healthy individuals, indicating that it is a therapeutic intervention associated with a higher quality of life compared to other modalities for end-stage renal disease.