Background and Aims Evaluation of Health-related quality of life (HRQoL) is an important, albiet neglected component of health care in patients with End Stage Renal Disease (ESRD). RAND-36 is a validated scoring system for evaluating HRQoL. Patients on hemodialysis experience decrease in various aspects of HRQoL. Various disease related and socio-economic factors influence HRQoL. There is limited data on HRQoL among patients of ESRD on hemodialysis from Indian subcontinent. In the present study, we aim to evaluate the HRQoL using RAND-36 score & the factors which influence it’s various aspects. In addition, we aim to evaluate patient perception of ease of access to dialysis related health care and its impact on RAND-36 score. Method This cross sectional, multi-centric study was performed in Nov 2020. A random sampling was employed to select the study participants. Patients with history of psychiatric illness, significant impairment of hearing, speech, or cognitive disturbances were excluded. RAND 36-Item Health Survey (Version 1.0) was used and circulated amongst dialysis patients across 10 dialysis centres in hospitals across India. Final scores were calculated using standard guidelines. A proprietary software from Bloom Value Corporation was used for data capture by electronic means and Power BI was used for analysis. Results 257 ESRD patients on hemodialysis completed the survey. Mean age was 52.9 years. 65.4 % participants were males, 39.69% were Diabetics and 75.88% had hypertension. Accessibility to healthcare was reported by 36% and 27.7% patients as ‘excellent‘ and ‘very good’ respectively. The mean scores in various scales were Physical Functioning (PF) 47.27±27.87 %, Role limitations due to physical health (RP) 54.18 ± 40.97 % , Role limitations due to emotional problems (RE) 55.38 ± 43.57 %, Energy/fatigue (EF) 49.80 ± 19.38 %, Emotional wellbeing (EW) 57.71 ± 22.04 %, Social functioning (SF) 58.02 ± 25.32%, Pain (BP) 68.28 ± 23.52 % and General Health (GH) 48.11 ±16.43%. Lower PF Scores were seen with higher age (NS), ≥ 2 comorbidities (NS). PF scores were higher in patients with Government insurance and higher perception of healthcare accessibility (NS). RP Scores were higher in males and with advancing age (NS). Employed patients had lower RP scores (p=0.009). RE scores were lower in patients with ≥ 2 comorbidities (NS) and among Employed patients (p=0.04). EF Scores were higher in males (p=0.07) and lower in patients with ≥ 2 comorbidities (NS). EW scores were higher in males (p=0.09) and among patients with higher perception of healthcare accessibility (NS). SF Scores were higher in males (p=0.08) and with higher perception of healthcare accessibility (NS). BP Scores were higher among patients with≥ 2 comorbidities (p=0.04) and higher perception of healthcare accessibility (NS). GH scores were higher with Government Insurance availability and higher perception of healthcare accessibility (NS). Conclusion To our knowledge this is the first multi-centric study conducted amongst ESRD patients in India, evaluating HRQoL using RAND36 scores. There is significant heterogeneity in patient reported outcomes and it’s determinants. Government Insurance support and a higher perception of healthcare availability have positive impact on many aspects of HRQoL. This is a valuable tool in executing patient centred care.

High blood pressure (BP) is an important risk factor for Cardiovascular diseases. The association of short term BP Variability (BPV) with target organ damage(TOD) is not clearly established. We conducted this observational study to evaluate the degree of concordance between Office Blood Pressure monitoring(OBPM) and Ambulatory Blood Pressure Monitoring (ABPM) and to study the effect of short term BPV on TOD. Patients attending clinics of the authors between January 2018 and August 2019 were enrolled. Their BP status was determined by OBPM and ABPM and the degree of concordance analysed. ABPM parameters between those with TOD and without TOD were compared using appropriate statistical measures. Data from 968 subjects (males 61.5%,mean age 59.39 ± 14.86 years) were analysed. Masked hypertension and white coat hypertension were seen in 138 (14.3%) and 50 participants (5.2%) respectively. There was moderate Concordance between ABPM and OBPM readings (Cohen’s kappa =0.692). There were 530(54.8%) non dippers and 189 (19.5%) reverse dippers. High morning surge (MS) was seen in 193(19.9%) and TOD in 225 (23.2%). Percent time elevation (PTE) of systolic BP (P=0.004,OR 1.009,95%CI 1.003,1.016) and diastolic BP in active period (p=0.034,OR 1.009,CI 1.001,1.017) and PTE of diastolic BP in passive period(p=0.006,OR 1.011,95%CI 1.003,1.018) ,as assessed by ABPM were significantly associated with TOD.Dipping status ,diurnal index and MS were not associated with TOD. ABPM is a useful tool for diagnosis and accurate categorisation of hypertension. Analysis of ABPM parameters helps to identify the patients with significant BP load who are at risk of developing TOD.

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hypocalcemia performed in patients after parathyroidectomy quickly subsided after calcium drug administration. Prophylactic intake of Calcitrol, calcium acetate and intravenous injection of calcium gluconate at the end of the hemodialysis procedure are effective. Conclusions: Calcium and phosphorus metabolism disorder was very common in our dialysis patients. Futher needs to be evualate serum levels of calcium, phosphorus, and iPTH in these patients early, and treat them more effectively in order to improve patients' quality of life, prevent complications and increase survival rate of dialysis patients.

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