Depressive symptoms but not chronic pain have an impact on the survival of patients undergoing maintenance hemodialysis

Abstract

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.

Hopelessness and Quality of Life Levels in Hemodialysis Patients

“…Hopelessness mean scores of the patients varied between 8.2±5.1 and 12.76±3.04 in the literature (13)(14)(15)(16). BHS mean scores of the patients were in the range of (9.63±5.56) in this study, too.…”

Predictors of disability in patients with chronic low back pain

“…Table I outlines the patients' socio-demographic data. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. The high catastrophizers (44.74%) had significantly higher scores (VAS -7 [5][6][7]), BDI -16 [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] and ODI -38 [34][35][36][37][38][39][40][41][42][43]…”

“…Apart from pain and disability the patients can present depression, due to chronic pain, and increased prescription drugs consumption [4]. Patients with chronic pain are more likely to develop depression and even higher levels of pain and worse health-related quality of life [5][6][7][8][9][10][11][12].…”

The Turkish version of the Neck Bournemouth Questionnaire in patients with chronic neck pain: a cultural adaptation, reliability, and validity study

“…In conclusion, the studies among adult populations show that the prevalence of chronic pain is higher in all countries [30]. Musculoskeletal system pain is being studied in a wide range from non-specific pain to pain as a result of an underlying pathological condition such as chronic renal failure [31]. It is known that chronic neck pain, which is very common, affects the quality of life of the patient negatively in physical, social and psychological aspects [5].…”