Interaction between anxiety, depression, and low resilience predicts poor prognosis in patients with chronic kidney...

Patients with chronic kidney disease (CKD), particularly those undergoing maintenance hemodialysis (MHD), often experience mental health issues. Recent studies have indicated a significantly elevated prevalence of anxiety and depression coupled with reduced resilience in this population. The complex interaction between these three factors is exacerbated by multiple negative influences. This study reviews recent advances in research on the relationship between mental health impairment, quality of life (QoL), and prognosis in patients with CKD. The findings revealed that prolonged MHD dependence, economic burden of healthcare, and other psychological factors diminish patients' resilience and intensify negative emotions (e.g., anxiety and depression). The interactions between negative emotions and physiology create a vicious cycle, deteriorating QoL and clinical outcomes. We propose that patients with long-term MHD-dependent CKD should be classified as a high-risk group for mental health impairments that need regular psychological screening and personalized psycho-medical interventions. This integrated management model may help improve negative emotions and disrupt the bidirectional psychophysiological interplay, offering a novel clinical pathway for improving the QoL and prognosis.