TITLE: Determination of Adequacy of Haemodialysis in Nigeria Background: Haemodialysis (HD) remains the most commonly available, accessible and utilized modality of renal replacement therapy (RRT) in end stage renal disease (ESRD) worldwide. However, information on the quantity or dose of dialysis provided as well as health related quality of life (HRQOL) achieved in managed patients is sparse in Nigeria, despite the increasing number of centres offering the service. This study assessed the dose and adequacy of haemodialysis as well as the HRQOL achieved in patients with ESRD undergoing maintenance HD in Nigeria and sought for the relationship between both. The study also sought for factors that determine HRQOL in these patients. Methodology: This was a cross-sectional study where 41 patients with End Stage Renal Disease (ESRD) had their socio-demographic, clinical and laboratory data assessed using a structured questionnaire while the HRQOL was assessed with the aid of SF-36 health survey questionnaire. Dialysis adequacy was assessed using equilibrated Kt/V derived from second generation logarithmic equation while standard Kt/V was estimated using Leypoldt Fixed-volume equation. Data was analysed using SPSS package version 14. Results: Their ages ranged between 19 and 84 year (median; 49 year) with a slight male preponderance (58.5%). Thirty-one patients (75.6%) were on twice weekly HD sessions while the remaining 10 (24.4%) had thrice weekly sessions. The median percentage reduction of urea (PRU), equilibrated kt/v and standard kt/v were 57%, 0.9 and 1.26 respectively. The median HRQOL scores for the eight SF-36 domains were Physical functioning 50, Role – physical 25, Bodily Pain 62, General Health 42, vitality 50, Social Functioning 37.5, Role – Emotional 66.7 and Mental Health 72. The frequency of HD per week and Standard Kt/V significantly correlated with most of the SF-36 quality of life domains (with r values of between 0.313 - 0.576 and 0.318 – 0.537 and corresponding p values of between 0.046 - <0.001 and 0.043 - <0.001 respectively) and this was sustained on multiple Regression analysis. Total serum protein, serum albumin levels and packed cell volume also correlated with more than one SF-36 quality of life domain. Conclusion: Adequacy of dialysis and HRQOL in our ESRD patients were suboptimal with the major determinants of HRQOL being the dose and frequency of HD, packed cell volume, serum albumin and serum creatinine levels