Depression, anxiety and adjustment in renal replacement therapy: a quality of life assessment

To measure the quality of life (QOL) of patients on RRT with regard to depression, anxiety, and adjustment to illness.

The study was conducted between 1996 and 1998 at a teaching hospital in Porto Alegre, Brazil. The study population included 125 patients (transplant n = 64, hemodialysis n = 42 and continuous ambulatory peritoneal dialysis [CAPD] n = 19).

The Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), and the Psychosocial Adjustment to Illness Scale (PAIS) were used for patient assessment. Results were analyzed using the Kruskall-Wallis, Mann-Whitney and ANOVA tests.

Depression scores were higher for hemodialysis patients compared with transplant patients (H = 15.22; p < 0.005). CAPD patients had intermediate scores (no statistical difference). As far as anxiety was concerned, no statistical difference was observed when the groups were compared. In terms of adjustment to illness, hemodialysis patients were significantly less well adjusted than transplant patients (H = 23.34; p < 0.001). Patients on CAPD had intermediate scores, with no significant difference compared with the other two groups.

The overall quality of life of transplant patients is higher than that of hemodialysis patients.