Abstract: Objective To investigate the relationship between serum phosphorus levels and health-related quality of
life (HDQOL) in hemodialysis patients. Methods A total of 190 patients with maintenance hemodialysis were selected. The
patients with blood phosphorus level >1.78 mmol/L were selected as the hyperphosphatemia group (n=108), and the patients with blood phosphorus level ≤1.78 mmol/L were selected as the non-hyperphosphatemia group (n =82). Data of age, gender, smoking history, hemodialysis access, frequency/week of hemodialysis treatment, complications and other clinical data were recorded. All the laboratory indicators before hemodialysis were recorded: serum calcium (Ca2+ ), serum phosphorus (P),
serum albumin (ALB), total parathyroid hormone (iPTH), total cholesterol (Tc), high density lipoprotein cholesterol (HDL-C),
low density lipoprotein cholesterol (LDL-C), triglyceride (TG), serum creatinine (Cr), blood uric acid (UA) and alkaline
phosphatase. The differences in iPTH, ALB and other indicators were compared between the two groups. Multivariate
Logistic analysis was performed to analyze the risk factors related to serum phosphorus level. The questionnaire of Kidney
Disease Quality of Life 36 (KDQOL-36) was used to evaluate the quality of life, and the scores of five subscales in the
KDQOL-36 were calculated. The differences of each subscale were compared between the two groups, and the relationship
between blood phosphorus level and quality of life was analyzed. Results Compared with the non-hyperphosphatemia
group, the patient age was smaller, the number of arteriovenous internal fistula were more, and the levels of Cr, ALB, iPTH
and Ca2+ were higher in hyperphosphatemia group (P＜0.05). Multivariate Logistic analysis indicated that high ALB (OR=
1.243,95%CI:1.082-1.427) and high iPTH (OR=1.001,95%CI:1.000-1.002) were risk factors for hyperphosphatemia (P＜
0.05). The subscale scores were significantly lower in the hyperphosphatemia group than those of the non-hyperphosphatemia group (P＜0.05). Conclusion The serum phosphorus level affects the quality of life of patients with
maintenance hemodialysis, while the quality of life is worse in hyperphosphatemia.

Key words: uremia, renal dialysis, quality of life, phosphorus, risk factors