Quality of life in patients with chronic kidney disease in low- and middle-income countries: protocol for a systematic review and meta-analysis.

Abstract

<h4>Introduction</h4>Chronic kidney disease (CKD) affects over 850 million people globally, with nearly 80% residing in low- and middle-income countries (LMICs). Despite this high prevalence, there is limited understanding of health-related quality of life (HRQOL) among patients with CKD in these resource-constrained settings. This systematic review and meta-analysis aims to quantify HRQOL scores across CKD stages and treatment modalities in LMICs.<h4>Methods and analysis</h4>We will conduct a comprehensive search of electronic databases including PubMed, Medline, Scopus and Web of Science, for observational studies published from January 2000 onwards in English or Russian. Eligible studies will include adult patients (≥18 years) with CKD stages 1-5, those on dialysis or kidney transplant recipients in LMICs. Two independent reviewers will screen studies, extract data and assess methodological quality using the Joanna Briggs Institute critical appraisal checklist. We will perform random-effects meta-analyses to pool HRQOL scores, stratified by CKD treatment groups. Heterogeneity will be assessed using I² statistics, with subgroup analyses and meta-regression conducted to explore potential sources of heterogeneity. The primary outcome will be pooled estimates of HRQOL scores across different CKD stages and treatment modalities in LMICs. Secondary outcomes will include subgroup analyses by income classification, geographical region and CKD stage depending on the availability of the data.<h4>Ethics and dissemination</h4>Ethical approval is not required for this study. Results will be submitted to a peer-reviewed, open-access journal and presented at scientific conferences.<h4>Prospero registration number</h4>CRD420251016382.