Anxiety, Comorbid Depression, and Dialysis Symptom Burden

Cukor, Daniel; Donahue, Stephanie; Tummalapalli, Sri Lekha; Bohmart, Andrew; Silberzweig, Jeffrey

doi:10.2215/cjn.01210122

Cited by 10 publications

(6 citation statements)

References 5 publications

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“…This finding is consistent with the results of Schouten et al’s [ 62 , 63 ] study of HD and peritoneal dialysis patients at 10 dialysis centers in the Netherlands with a mean anxiety level of 10.3 ± 10.1. However, our results were higher than those of Zhang et al [ 64 ], Kurtgoz et al [ 65 ], Zahedian et al [ 66 ], Cukor et al [ 46 ], Wu et al [ 67 ], and Nadort et al [ 47 ]. This inconsistency might be due to different countries, single- or multi-centers, eligible participants, with or without COVID-19 infection, and before or during the COVID-19 pandemic.…”

Section: Discussioncontrasting

confidence: 87%

“…Due to different methodologies, the literature shows inconsistent results for some factors related to sociodemographic [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], psychological [ 23 , 34 , 36 , 37 , 38 , 39 ], and spiritual [ 23 , 40 , 41 , 42 , 43 ] aspects, and clinical characteristics [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ] of hemodialysis patients. However, religion [ 23 , 39 , 40 , 41 , 42 , 43 ], social support [ 44 , 45 ], anxiety, and depression during COVID-19 [ 46 , 47 ], spiritual well-being [ 23 , 39 , 40 , 41 , 42 , 43 ], perceived health status […”

Section: Introductionmentioning

confidence: 99%

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Factors Related to Quality of Life of Hemodialysis Patients during the COVID-19 Pandemic

et al. 2023

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Taiwan had the second highest number globally of end-stage renal disease patients undergoing treatment in 2018. A meta-analysis of Chen et al. (2021) showed the incidence and mortality rates of COVID-19 were 7.7% and 22.4%, respectively. Few studies have explored the effects of patients’ self-participation and perceptions of hemodialysis on their quality of life. This study aimed to explore the factors related to hemodialysis patients’ quality of life during the COVID-19 pandemic. This study was a descriptive correlational study. Patients were recruited (n = 298) from the hemodialysis unit of a medical center in northern Taiwan. Variables included patients’ sociodemographic, psychological, spiritual, and clinical characteristics (i.e., perceived health level, comorbidities, hemodialysis duration, weekly frequency, transportation, and accompaniment during hemodialysis), perceptions of hemodialysis, self-participation in hemodialysis, and health-related quality of life (KDQOL-36 scale). Data were analyzed using descriptive and bivariate and multivariate linear regression. Multivariate linear regression, after adjusting for covariates, showed that anxiety, self-perceived health status, two vs. four comorbidities, and self-participation in hemodialysis were significantly associated with quality of life. The overall model was significant and accounted for 52.2% (R2 = 0.522) of the variance in quality of life during hemodialysis (adjusted R2 = 0.480). In conclusion, the quality of life of hemodialysis patients with mild, moderate, or severe anxiety was poorer, whereas that of patients with fewer comorbidities, higher self-perceived health status, and higher self-participation in hemodialysis was better.

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Section: Discussioncontrasting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Factors Related to Quality of Life of Hemodialysis Patients during the COVID-19 Pandemic

et al. 2023

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“…This is similar to a large study of Japanese hemodialysis patients in which depressive symptoms were significantly associated with the risk of developing pruritus 34 and a recent finding that depressive symptoms are associated with increased symptom burden in US hemodialysis patients. 14 Physician-diagnosed depression was also a risk factor for prevalent pruritus in participants of CKDopps with nondialysis CKD. 1 It is possible that the association between depressive symptoms and pruritus may be mediated by poor sleep, as key regulatory mechanisms of the skin are altered during sleep.…”

Section: Discussionmentioning

confidence: 99%

“…12 For example, the prevalence of depressive symptoms among patients with CKD is high, 13 and, in cross-sectional analyses, depressive symptoms are associated with pruritus 1 and overall symptom burden. 14 Furthermore, elucidating potential biopsychosocial mechanisms causing pruritus in CKD is crucial to improving treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

Incidence and Risk Factors for Pruritus in Patients with Nondialysis CKD

Wulczyn

Rhee

Myint

et al. 2023

CJASN

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Background:Pruritus is a common symptom experienced by patients with nondialysis CKD, but risk factors for incident pruritus in this patient population have not been evaluated.Methods:We identified 1,951 participants with CKD in the Chronic Renal Insufficiency Cohort Study without pruritus at the baseline assessment. Pruritus was assessed by the Kidney Disease Quality of Life-36 instrument, and moderate-to-severe pruritus was defined as a response of 3 or higher on a Likert scale of 1 to 5. We used time-updated multivariable joint models to evaluate the association of patient clinical characteristics, eGFR, and laboratory parameters with incident pruritus.Results:Over a median follow-up of 6 years, 660 (34%) participants developed incident moderate-to-severe pruritus, with a higher incidence rate observed among participants with more advanced CKD. In multivariable models, the hazard ratio (95% CI) for pruritus associated with a 10 mL/min/1.73 m2lower eGFR was 1.16 (1.10 - 1.23). Older age (≥65 years), higher body mass index, diabetes, current smoking, opioid use, depressive symptoms, and serum parathyroid hormone were also associated with a higher risk of incident pruritus, while low serum calcium (<9 mg/dL) was associated with a lower risk (allp<0.05). Serum phosphate was not associated with incident pruritus in the primary analysis.Conclusions:A substantial proportion of patients with nondialysis CKD develop moderate-to-severe pruritus. While lower eGFR is associated with the risk of pruritus, other comorbidities, particularly depressive symptoms, are potential risk factors.

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“…1 However, the importance of co-occurring anxiety in HD patients with major depressive disorder remains understudied. 2…”

Section: Introductionmentioning

confidence: 99%

Anxiety and Response to Treatment of Depression in People Undergoing Maintenance Hemodialysis

Cukor

Rue

Heagerty

et al. 2023

CJASN

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Anxiety, Comorbid Depression, and Dialysis Symptom Burden

Cited by 10 publications

References 5 publications

Factors Related to Quality of Life of Hemodialysis Patients during the COVID-19 Pandemic

Factors Related to Quality of Life of Hemodialysis Patients during the COVID-19 Pandemic

Incidence and Risk Factors for Pruritus in Patients with Nondialysis CKD

Anxiety and Response to Treatment of Depression in People Undergoing Maintenance Hemodialysis

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