IntroductionMore than 1/3 of patients with end-stage renal disease who are in a chronic dialysis program suffer from chronic pain and depression/anxiety. The aim of the study was to determine the impacts of symptoms of depression/anxiety, chronic pain and quality of life (QoL) on 6-year patient survival.Material and methodsObservational study of end-stage renal disease patients on maintenance hemodialysis (n = 205) who met the inclusion criteria. Patients from three dialysis centers in Lower Silesia were asked to complete a battery of validated questionnaires: the Hospital Anxiety and Depression Scale (HADS), the 36-item Short Form Health Survey Questionnaire, the Verbal Rating Scale (VRS) and the Visual Analog Scale (VAS). Clinical and biochemical data (dialysis adequacy) were recorded.ResultsOne hundred thirty from 205 enrolled hemodialysis patients (63.4%) suffered from chronic pain. Patients with pain were on maintenance dialysis for longer times and had higher levels of parathyroid hormone, more depressive symptoms and a lower QoL than those without pain. In the 6-year period, 96 (46.8%) patients died. The most common cause of death was cardiovascular disease in 44 (45.8%) patients. Highly depressed patients (HADS depression score > 8) exhibited higher mortality (< 8 vs. > 8 points; p = 0.016) independent of age, diabetes, cardiovascular disease, C-reactive protein or albumin level.ConclusionsChronic pain, although common among hemodialysis patients, did not lower survival. Depressive symptoms are an important predictor for all-cause mortality in hemodialysis patients, with the relationship independent of nutritional or inflammatory status.

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were formed by creatinine clearance measured from 24 h urine (Table 1). For 13,905 patients who were over 18 years of age, the number of patients from cut-off values of Scr and estimated glomerular filtration rate (eGFR) formula at each CKD stage were compared. The four-variable Modification of Diet in Renal Disease Study equation using Japanese race factor was applied for eGFR. 3 The number of patients per CKD stage, which was classified using the newly established Scr cut-off values, showed very similar results to the number of patients classified using eGFR cut-off values (Table 1). In conclusion, setting the cut-off values would be necessary when applying Scr to CKD. 1. Jain AK, McLeod I, Huo C et al. When laboratories report estimated glomerular filtration rates in addition to serum creatinines, nephrology consults increase.

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