End-stage kidney diseases in areas of conflict; patients' perspective and access to hemodialysis services in Northwest Syria

End-Stage Kidney Disease (ESKD) is a debilitating condition that poses unique challenges in conflict-affected regions. This study explores the experiences of ESKD patients in Northwest Syria, where healthcare access is complicated by ongoing conflict. The study delves into patients' perspectives on their condition, their utilization of hemodialysis services, and the barriers they face in accessing vital treatment. The study utilized cross sectional method and the data for this research was collected through telephone interviews with 101 ESKD patients from 12 selected hemodialysis units in Northwest Syria. Findings reveal diverse sociodemographic, with the mean age 50.3 ± 16.7 (7 to 81 years). Notably, 55.4% were males. Around one third (28.7%) of surveyed patients reported problems such as missing or being unable to access their hemodialysis sessions in the previous year. The study investigated the determinants of hemodialysis service access for ESKD patients, residency stability was found to positively impact access, while frequent relocations disrupted continuity. The utilization of multiple hemodialysis units was linked to increased access challenges. Educational levels correlated with accessibility, as lower education was associated with a higher likelihood of inaccessibility. This study highlighted the intricate challenges faced by ESKD patients in NW Syria, emphasizing the diverse sociodemographic aspects and the critical role of residency stability, unit utilization, and education in hemodialysis access.