Background: The Kidney Disease and Quality of Life Short Form (KDQOL-SF™ 1.3) is widely used to assess health-related quality of life (HRQoL) in patients with end-stage renal disease. However, no prior validation had been conducted in Kazakhstan, where both Kazakh and Russian are commonly spoken. This study aimed to validate the Kazakh and Russian versions of the KDQOL-SF™ 1.3 and to identify predictors of HRQoL among hemodialysis patients in Kazakhstan. Methods: A cross-sectional survey was conducted among 217 adult hemodialysis patients from February to April 2025 using a mixed-methods approach (in-person interviews and online data collection). Psychometric testing included Cronbach’s alpha, floor and ceiling effect analysis, and Pearson correlations with self-rated overall health. Multiple linear regression was used to identify predictors of the Kidney Disease Component Summary (KDCS), Physical Component Summary (PCS), and Mental Component Summary (MCS) scores. Results: Both language versions demonstrated acceptable to excellent internal consistency (Cronbach’s α = 0.692–0.939). Most subscales were significantly correlated with self-rated health, supporting construct validity. Regression analyses revealed that greater satisfaction with care, better economic well-being, and more positive dialysis experiences were significant predictors of higher KDCS and MCS scores. Lower PCS scores were associated with female gender, comorbidities, and financial burden. Importantly, financial hardship and access challenges emerged as strong negative influences on HRQoL, underscoring the role of socioeconomic and care-related factors in patient well-being. Conclusions: The KDQOL-SF™ 1.3 is a valid and reliable tool for assessing quality of life among Kazakh- and Russian-speaking hemodialysis patients in Kazakhstan. Integrating this instrument into routine clinical practice may facilitate more personalized, patient-centered care and help monitor outcomes beyond traditional clinical indicators. Addressing economic and access-related barriers has the potential to significantly improve both physical and mental health outcomes in this vulnerable population.

Background: Kidney transplantation (KTx) is a life-saving intervention, but post-transplant psychological well-being and treatment adherence remain critical challenges. This study aimed to (1) develop and validate a Health and Treatment-Related Anxiety Scale in Kazakh- and Russian-languages, (2) identify predictors of such anxiety, and (3) examine its impact on adherence to treatment and well-being among kidney transplant recipients in Kazakhstan. Methods: A cross-sectional study was conducted among 223 adult kidney transplant recipients. The newly developed anxiety scale was tested for psychometric validity using exploratory and confirmatory factor analyses. Internal consistency and criterion-related validity were assessed through item-rest correlations and correlation with related outcomes. Multiple linear regression and mediation models were used to identify predictors of health and treatment-related anxiety and psychological mechanisms affecting treatment adherence and well-being. Results: The scale demonstrated strong psychometric properties with a one-factor structure and high internal consistency (Cronbach’s α=0.893). Anxiety negatively correlated with both treatment adherence (p<0.001). Regression analysis identified employment under disability status and perceived availability of post-KTx monitoring as protective factors. Emotional support and anxiety levels significantly predicted treatment adherence. Mediation analyses revealed that anxiety partially mediated the relationship between perceived post-KTx monitoring and both adherence and well-being (p<0.05). Conclusion: The validated anxiety scale is a reliable tool for assessing psychological vulnerability in kidney transplant recipients. Addressing treatment-related anxiety may enhance post-transplant care by improving both adherence and emotional well-being.