Abstract
BackgroundPatients diagnosed with chronic kidney disease (CKD) report increased distress associated with their clinical diagnosis. Distress in patients with predialysis CKD, has been linked to several adverse events; including increased risk of hospitalisation, early dialysis initiation and even death, suggesting that distress is a matter of great concern during routine care in predialysis CKD.AimsThe present study aimed to assess the nature of illness perceptions and the level of distress in a CKD cohort diagnosed with different stages of kidney disease. It also aimed to explore the correlates of distress and to create a model for distress and its associated predictors making use of hierarchical regression analysis.MethodsA sample of 200 patients diagnosed with Chronic Kidney Disease were recruited for this study from the nephrology outpatient clinics of Mater Dei Hospital, Malta. The participants were assessed for their; illness perceptions, treatment beliefs, level of depression and anxiety, coping style, as well as treatment adherence. Routine clinical information was also collected for participants, including a co-morbidity score.ResultsA percentage of 33.5% of the participants reported moderate distress, whilst 9.5% reported severe distress. Stronger illness identity, a perception of timeline as being increasingly chronic or cyclical in nature, greater consequences and higher emotional representations were associated with more advanced stages of CKD. In contrast, lower personal and treatment control and poorer illness coherence were associated with more advanced stages of CKD. Results from the hierarchical regression analysis showed that illness perceptions contributed significantly to distress over and above the clinical kidney factors. Being female, having low haemoglobin and specific illness perceptions including; perceptions of greater symptomatology, longer timeline, low personal control and strong emotional representations, as well as resorting to maladaptive coping, were all significantly associated with distress symptoms. Nevertheless, illness perceptions accounted for the greatest variance in distress thus indicating that the contribution of illness perceptions is greater than that made by the other known covariates.ConclusionIllness perceptions hold a principal role in explaining distress in CKD, relative to other traditional covariates. For this reason, illness perceptions should be addressed as a primary modifiable component in the development of distress in CKD.
Highlights
Patients diagnosed with chronic kidney disease (CKD) report increased distress associated with their clinical diagnosis
Illness perceptions should be addressed as a primary modifiable component in the development of distress in CKD
Conclusions it is possible to recommend that early diagnosis and treatment of depression and anxiety and close monitoring are especially important in CKD patients to improve their quality of life, whilst improving disease prognosis by delaying the start of dialysis
Summary
Patients diagnosed with chronic kidney disease (CKD) report increased distress associated with their clinical diagnosis. Distress in patients with predialysis CKD, has been linked to several adverse events; including increased risk of hospitalisation, early dialysis initiation and even death, suggesting that distress is a matter of great concern during routine care in predialysis CKD. Chronic kidney disease (CKD) is found to affect both the structure and the function of the kidney, resulting in the progressive and irreversible loss of kidney function, as the condition degenerates from early stages to later stages of CKD [1]. As eGFR decreases and patients approach ESKD, they require more invasive treatment and resorting to lifestyle and dietary management is no longer sufficient to manage the symptoms associated with renal disease, dialysis is required. Dialysis allows small and middles sized-molecules to be removed from the blood (e.g. metabolic end-products) or through the peritoneum (e.g. removal of solutes), whilst removing fluid, through the use of two basic modalities; haemodialysis (HD) and peritoneal dialysis (PD) [6, 7]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
