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Psychological Indices and Health-Related Quality of Life in Renal Replacement Therapy: A Three Groups Cross-Sectional
Maryam Emadzadeh1,2, Negar Morovatdar3, Mohammad Javad Mojahedi4
1Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
Kidney transplantation offers superior quality of life for end-stage kidney disease patients compared to dialysis. Mental health support is crucial for all patients with end-stage kidney disease, regardless of treatment.
Area of Science:
- Nephrology
- Public Health
- Psychiatry
Background:
- Chronic kidney disease (CKD) is a major global health issue.
- End-stage kidney disease (ESKD) necessitates renal replacement therapy: hemodialysis (HD), peritoneal dialysis (PD), or kidney transplantation (KT).
- ESKD significantly impacts patients' physical health, mental well-being, and overall quality of life, with limited research in Iran.
Purpose of the Study:
- To investigate the association between different renal replacement therapies (HD, PD, KT) and quality of life, depression, anxiety, and social support in ESKD patients in Iran.
- To compare the health burdens and outcomes across various ESKD treatment modalities.
Main Methods:
- A cross-sectional study involving 215 ESKD patients (66 HD, 70 PD, 79 KT) in Mashhad, Iran.
- Data collected via demographic checklist, KDQOL-SF questionnaire, Hamilton depression and anxiety inventories, and Cassidy inventory for problem-solving and social support.
- Statistical analysis included regression modeling to adjust for confounders using SPSS 11.5.
Main Results:
- Kidney transplant recipients were younger and reported significantly higher quality of life scores in both general and specific domains compared to HD and PD patients, even after adjusting for age.
- High prevalence of depression (60-65%) and moderate prevalence of anxiety (21-26%) were observed across all groups, with no significant differences between treatment modalities.
- Social support was consistently high (70-82%) among all ESKD patients, irrespective of their treatment.
Conclusions:
- Kidney transplantation is associated with better quality-of-life outcomes than hemodialysis and peritoneal dialysis.
- The findings underscore the importance of organ donation programs for improving patient outcomes.
- Prioritizing early detection and intervention for depression and anxiety is essential for all ESKD patients, including those undergoing dialysis and transplantation.
Background:
Chronic kidney disease (CKD) is a significant global health concern. Patients in the last stage of CKD, also known as end stage kidney disease (ESKD), need to use one of the methods of renal replacement therapy including hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KT). ESKD adversely affects physical and mental health, as well as overall quality of life. However, limited research has explored the association between these health burdens and treatment modalities in Iran.
Methods And Materials:
This cross-sectional study included 215 patients with ESKD undergoing HD (n = 66), PD (n = 70), and KT (n = 79) at treatment centers in Mashhad, Iran. A checklist of demographic information, quality of life questionnaire specific for kidney disease patients (Kidney Disease Quality of Life Short Form [KDQOL-SF], version 1.3), Hamilton depression and anxiety inventories, and the Cassidy inventory for problem-solving and social support were distributed among patients. A regression model was employed to adjust for potential confounders, and statistical analysis was conducted using SPSS 11.5.
Results:
Kidney transplant recipients were younger than patients in the HD and PD groups and exhibited significantly higher mean scores in most domains of the KDQOL, both in general and specific domains. After adjusting for confounding variables such as age, transplant patients were found to have the highest quality of life scores in specific domains. Depression prevalence was high, ranging from 60% to 65% across all groups, with no significant intergroup differences. Anxiety prevalence ranged from 21% to 26%, also without significant differences. Social support was reported as high among ESKD patients (70%-82%) with no variation between treatment modalities.
Conclusion:
KT was associated with better quality-of-life outcomes compared to HD and PD, highlighting the potential benefits of organ donation programs. Given the substantial burden of mental health issues among ESKD patients, early detection and intervention for depression and anxiety should be prioritized in both dialysis and transplant populations.
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