Gender differences in biochemical characteristics and health-related quality of life among hemodialysis patients

Women receiving hemodialysis face a range of social and medical challenges that can significantly affect their treatment and overall quality of life. We aimed to assess whether there are gender differences in hemodialysis by comparing biochemical characteristics and dialysis parameters between males and females. We used Kidney Disease Quality of Life Short Form (KDQOL-SF™ 1.3) questionnaire to compare health- related quality of life. A cross-sectional study was conducted involving 340 prevalent hemodialysis patients from three dialysis centres. Data were collected between August 2024 and February 2025. Sequential general linear models (GLM) were applied to assess gender differences in Physical component summary scores and Mental component summary scores: Model 1 (unadjusted), Model 2 (adjusted for physiological variables: age, haemoglobin, albumin, PTH, and Kt/V), and Model 3 (further adjusted for social variables: marital status, education, and employment). Statistical significance was set at p < 0.05. Haemoglobin levels were similar in both genders with a mean of 9.2 g/dL. Serum calcium (8.6 vs. 8.4 mg/dL, p = 0.25) phosphate levels (5.1 vs. 4.9 mg/d, p = 0.3) were similar. Parathyroid hormone was higher in females compared to males (589 ± 551 pg/mL vs. 744 ± 708 pg/mL, p = 0.026). There was no difference in dialysis adequacy, KT/V (1.55 ± 1.1 vs. 1.54 ± 0.9, p = 0.4). Vascular access type was similar, AVF (89.0% vs. 87.9%, p = 0.95). There was no difference in PCS (29.11 ± 6.75 vs. 28.93 ± 6.53, p = 0.807). In contrast, Mental component summary was higher in males (45.05 ± 5.98 vs. 41.07 ± 6.01; p < 0.001). After adjustment for all covariates, gender remained a strong independent predictor of Mental component summary, with females scoring significantly lower than males (B = − 3.90, 95% CI –5.24, − 2.57, p < 0.001). In this study there were no significant gender differences in biochemical characteristics or dialysis adequacy parameters. Mental component summary was significantly lower in female patients, and this difference remained after adjustment for physiological and social covariates emphasizing the need for gender-sensitive, psychosocially informed care models.