Religiosity, spirituality and quality of life of dialysis patients: a systematic review

  • Alexandru Burlacu
  • Bogdan Artene
  • Ionut NistorEmail author
  • Smaranda Buju
  • Daniel Jugrin
  • Ionut Mavrichi
  • Adrian Covic
Nephrology - Review



End-stage renal disease (ESRD) patients often report a combination of disturbing physical symptoms and psychological distress which result in significantly reduced quality of life (QoL). Coping with a chronic disease is a complex matter involving also the family and a multi-disciplinary team. Recently, observational studies suggested that spirituality (S) and religiosity (R) are two important determinants in coping with a chronic/terminal disease. Both concepts were studied in various settings, involving ESRD and QoL. This systematic review aims to synthesize all instruments used to assess R/S, to examine the strategies evaluating QoL of dialysis patients and to analyse their correlations.


In accordance with the PRISMA, a systematic search was conducted in PubMed and SCOPUS (between Jan 1980—Dec 2018, PROSPERO number CRD42019116837). Eligible studies included patients on dialysis therapy, religiously/spiritually assessed and contained QoL evaluation.


Of the initial 311 studies, 261 papers were excluded. Consequently, 50 papers with a total 9265 patients were available for inclusion. From a list of 177 R/S scales available worldwide, we identified 24 tools. We organized all QoL parameters into 10 classes. In all studies, R/S variables were positively correlated with at least one QoL variable.


In this systematic review, we synthesized the studies involving R/S assessment in dialysis patients and their benefit on QoL. R/S has a positive impact on most QoL parameters in 5D-CKD. We suggest that nephrology guidelines on palliative care and/or elderly should include specific recommendations on R/S support and opportunities for integrated specific therapies.


Dialysis End-stage renal disease Religiosity Spirituality Quality of life 



AB was supported by the Romanian Academy of Medical Sciences and European Regional Development Fund, MySMIS 107124: Funding Contract 2/Axa 1/31.07.2017/ 107124 SMIS. AC was supported by a grant of Ministery of Research and Innovation, CNCS - UEFISCDI, project number PN-III-P4-ID-PCE-2016-0908, contract number 167/2017, within PNCDI III.

Compliance with ethical standards

Conflict of interest

none declared.

Supplementary material

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Supplementary material 1 (DOCX 36 KB)
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Supplementary material 2 (DOCX 63 KB)


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© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of Interventional Cardiology - Cardiovascular Diseases Institute‘Grigore T. Popa’ University of MedicineIasiRomania
  2. 2.Department of Nephrology‘Grigore T. Popa’ University of MedicineIasiRomania
  3. 3.Department of Teacher TrainingAsachi’ Technical UniversityIasiRomania
  4. 4.Theology, Center for Studies and Interreligious and Intercultural DialogueUniversity of BucharestBucharestRomania
  5. 5.Sociology Department, Faculty of TheologyUniversity of BucharestBucharestRomania
  6. 6.Dialysis and Renal Transplant Center -‛C.I. Parhon’ University Hospital, and’Grigore T. Popa’Nephrology Clinic, University of MedicineIasiRomania
  7. 7.The Academy of Romanian Scientists (AOSR)BucharestRomania

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