CHRONIC KIDNEY DISEASE AND ITS IMPLICATIONS OVER MUSCULOSKELETAL SYMPTOMS IN WAR CONFLICT ZONE: A CROSS-SECTIONAL STUDY
Date
2026-05-12
Authors
Mohammad F. Zhour
Mohammed Imad
Salah Wajdi Alaloul
Khalil Mostfa Alinaby
Seraj Hazem Alamassi
Hesham Fawzi Al Amassi
Mohammed Zughbur
Arslan Ahmed
Kashif Memon
Ashraf Joma Al Bayya⁵
Journal Title
Journal ISSN
Volume Title
Publisher
Deanship of Scientific Research - Al-Quds University
Abstract
Background: Chronic kidney disease (CKD) patients undergoing maintenance hemodialysis (HD) commonly experience musculoskeletal (MSK) symptoms that substantially reduce quality of life. In active conflict zones such as the Gaza Strip, where healthcare infrastructure is severely disrupted and war-related stressors are widespread, the burden of MSK symptoms is expected to be markedly amplified.
Objectives: This multicenter cross-sectional study aimed to assess the prevalence of MSK symptoms and identify sociodemographic, clinical, and war-related predictors among HD patients in Gaza during ongoing hostilities.
Methods: The study was conducted between April and May 2025 across five operational HD centers in the Gaza Strip. A total of 336 adult patients on maintenance hemodialysis for ≥3 months completed the Arabic-validated Nordic Musculoskeletal Questionnaire (NMQ) through face-to-face interviews. Data on sociodemographic characteristics, clinical factors, dialysis adequacy, and war-related exposures were also collected. Chi-square tests and multivariate binary logistic regression were used to identify independent predictors of MSK symptoms.