Psychometric properties of kidney disease quality of life-36 (KDQOL-36) in dialysis patients in Indonesia

Objective The study aimed to evaluate the psychometric properties of KDQOL-36 Bahasa Indonesia in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients in Indonesia. Methods The psychometric analysis was conducted in three hospitals offering both HD and CAPD. The validity was assessed through structural, convergent, and known-group validity, while reliability was evaluated using internal consistency and test-retest reliability. Results The study involved 370 participants of which 71% received HD treatment. No floor and ceiling effects (< 10%) were identified. Confirmatory factor analysis supported a good model fit for both generic and kidney-specific domains, while exploratory factor analysis revealed three factors for kidney-specific domains and only three items with a loading factor below 0.4. Convergent validity showed positive correlations between kidney-specific domains, generic domains, and EQ-5D. The comparison of quality of life among subgroups based on dialysis type and whether or not patients had diabetes supported the hypotheses of known-group validity. Cronbach's alpha and omega values had demonstrated good internal consistency. Test-retest reliability indicated burden of kidney disease had good reliability, while other domains had moderate reliability. Conclusion The study supports the validity and reliability of both generic and kidney-specific domains of KDQOL-36 Bahasa Indonesia to evaluate quality of life in patients with HD and CAPD in Indonesia. As health-related quality of life is a crucial predictor of patient outcomes, this report contributes new evidence about validity and reliability to recommend the use of KDQOL-36 Bahasa Indonesia in dialysis centers.