This questionnaire-based study included 69 patients from the Republic of Guinea with end-stage renal disease (ESRD) and was conducted over 12 months. The factors that affected their quality of life (QoL) were determined. The included ESRD patients had an estimated creatinine clearance (CCr) of <15 mL/minute using MDRD formula. We used the SF36 question-naire and classified the results into two groups: Scores<50/100 as poor QoL and scores 50/100 as good QoL. Factors that determined the QoL were cessation of all activities and additional effort required, severe or mild pain, good or bad health, and reduced or not reduced social and physical activities. Of the 69 patients, 32 (46.3%) had a good QoL and 37 (53.7%) had a poor QoL. The estimated CCr was similar in both groups. The average age of the poor QoL group was 54±4 years, the good-QoL group's average age was of 47.6±4 years (P=0.01). Patients with a good QoL had better overall health, but this was not statistically significant [OR=0.42 (0.14-1.28); P=0.14]. Patients with a poor QoL had more severe pain (P=0.002); however, good QoL did not protect against mental problems [OR=46.67 (8.18-351.97); P=0.0001]. Mental status (P=0.01) and social activities (P=0.001) were reduced, and there were more comorbidities in the poor-QoL group (29.7%, with >4, P=0.01). Good QoL was associated with younger age, fewer comorbidities, less severe physical pain, and fewer physical or social limitations. QoL could be increased by improving comorbidity treatments, giving more effective pain control, and providing more assistance for social and physical limitations.