Depression, Anxiety, Activities of Daily Living, and Quality of Life Scores in Patients Undergoing Renal Replacement Therapies

Abstract

The aim of this study was to investigate anxiety, depression, quality of life (QOL), and activities of daily living (ADL) among our hemodialysis and renal transplant subjects. Psychological disorders were prevalent among patients with end-stage renal disease (ESRD), adversely affecting QOL and ADL. All patients ≥18 years under renal replacement therapy were asked to participate in the study. Patients completed 4 questionnaires including the Symptom Checklist-90 subscales of depression and anxiety, the Nottingham Extended ADL scale, and the Duke Health Profile questionnaire. We examined a total of 100 transplant and 63 hemodialysis patients. Transplant patients were significantly younger, better educated, and with lower morbidity than the hemodialysis patients. Transplant patients also showed less depression and anxiety as well as better ADL and physical health. Of the variance in anxiety scores, 12.2% was explained by gender and the presence of cardiac disease ( P = .022). For depression, replacement therapy and gender explained 16.4% of the variance ( P = .004). Replacement therapy accounted for 35.3% of the variance of the ADL score ( P < .001), while together with the additional factors of age, gender, and education these 52.8% ( P = .007) was accounted for. For the general health score, gender, and cardiac disease explained 11.6% of the variance ( P < .001). This study demonstrated that depression and anxiety are more prevalent among hemodialysis patients compared with kidney transplant subjects; the method of treatment was a major contributor to the variance in ADL and depression scores among ESRD patients.