Chronic kidney disease duration and suicide risk among maintenance hemodialysis patients in China
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Published on: April 4, 2025
Xinyue Wang1,2, Xinmei Hao2, Mi Ma3
1School of Mental Health, Jining Medical University, Shandong, China.
Insights
Chronic kidney disease duration significantly increases suicide risk in maintenance hemodialysis patients. Early end-stage renal disease and dialysis treatment further elevate this risk, highlighting the need for targeted interventions.
Area of Science:
- Nephrology
- Psychiatry
- Public Health
Background:
- Chronic kidney disease (CKD) is a growing global health concern.
- Maintenance hemodialysis (MHD) patients represent a vulnerable population with complex health needs.
- Understanding factors influencing suicide risk in CKD patients is crucial for preventative care.
Purpose of the Study:
- To investigate the association between the duration of chronic kidney disease (CKD) and suicide risk.
- To examine the influence of end-stage renal disease (ESRD) and hemodialysis treatment duration on suicide risk in CKD patients.
- To identify specific patient subgroups with elevated suicide risk within the CKD population.
Main Methods:
- A cohort of maintenance hemodialysis (MHD) patients in China was enrolled.
- Demographic and disease characteristics were collected via questionnaire.
- Suicide risk was assessed using the Suicide Risk Assessment Scale.
Main Results:
- Over 40% of MHD patients exhibited significant suicide risk.
- Longer CKD duration was independently associated with increased suicide risk (P < .001).
- Interactions between CKD duration, ESRD duration, and hemodialysis duration significantly impacted suicide risk.
Conclusions:
- CKD duration is a critical, independent predictor of suicide risk in MHD patients.
- Early stages of ESRD and shorter hemodialysis treatment durations, combined with prolonged CKD, confer the highest suicide risk.
- These findings underscore the importance of integrated mental health support for CKD patients undergoing dialysis.
Background:
Our aim was to investigate the relationship between chronic kidney disease (CKD) duration and suicide risk among maintenance hemodialysis patients in China.
Methods:
Patients with end-stage renal disease (ESRD) who received MHD were enrolled. The demographic and disease characteristics of MHD patients were collected using a self-designed basic information questionnaire. The Suicide Risk Assessment Scale was used to assess suicide risk.
Results:
A total of 543 (40.8%) patients had suicide risk with Nurses' Global Assessment Scale for Suicide Risk scores ranging from 1 to 19 points. After adjusting for age, gender, disease conditions and mental state, the odds ratios of different CKD duration for suicide risk were 1.00, 2.02, 3.03 and 2.71, respectively (P for trend <.001). There were significant interactions between CKD duration and ESRD duration in relation to suicide risk (P for interaction <.001). There were also interactions between CKD duration and hemodialysis treatment duration, and suicide risk (P for interaction = .01). Patients with ESRD duration of ≤28 months or hemodialysis treatment duration of ≤24 months had the highest risk of suicide when the duration of CKD was 63-94 months, about 2-10 times higher than the other time groups.
Conclusions:
We found that CKD duration was associated with an increased risk of suicide in maintenance hemodialysis patients in China, independently of other risk factors. Early ESRD and maintenance hemodialysis were associated with suicide in CKD patients.
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