Abstract
Anxiety is a frequent and serious complication of children and adolescents receiving dialysis. Low serum vitamin D levels have been associated with anxiety in non-pediatric patients. This study sought to examine the possible association between serum vitamin D levels and the presence of anxiety in children and adolescents with dialysis in China. A total of 156 pediatric patients who were on hemodialysis or peritoneal dialysis and 100 healthy controls were included in the current study. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured by using a competitive protein-binding assay. Anxiety was assessed by using the Chinese version of the Screen for Child Anxiety Related Emotional Disorders (SCARED, = 25 as cutoff). Among 156 patients, 110 had a current anxiety (70.5%) and 46 did not (29.5%). Serum levels of 25(OH)D were significantly lower in patients with anxiety than in normal controls (19.4 ± 10.3 vs. 38.6 ± 15.5 ng/ml, P < 0.001). Serum 25(OH)D levels (≤15.0 ng/ml) were independently associated with the existent of anxiety in children and adolescents receiving dialysis (OR 4.650, 95% CI 1.663–13.001, P = 0.003). Our research demonstrates that low serum levels of vitamin D are independently associated with anxiety among children and adolescents on dialysis, which needs to be confirmed in future experimental and clinical studies.
Highlights
Psychiatric disorders such as anxiety and depression are prevalent in children and adolescents with chronic kidney disease, especially in those on dialysis1
The recognition and diagnosis of anxiety is of importance because the presence of anxiety has been associated with reduced quality of life and poor social relationships in pediatric patients receiving dialysis4
Of the 169 dialysis patients screened for study entry, we excluded individuals with missing information on serum levels of vitamin D (n = 8), with a history of depression and anxiety (n = 3), leukaemia (n = 1), and losing a family member in the past 30 days (n = 1)
Summary
Psychiatric disorders such as anxiety and depression are prevalent in children and adolescents with chronic kidney disease, especially in those on dialysis. Data on prevalence and correlates of anxiety in children and adolescents with dialysis is limited. Studies in animals have identified that mice lacking the vitamin D receptors gene showed an increase in anxiety-like behavior. No study has examined the association between vitamin D and anxiety in children and adolescents with dialysis. The aim of the current study was to investigate the prevalence and correlates of anxiety in children and adolescents with dialysis in China. We examined whether low levels of vitamin D are associated with anxiety in children and adolescents with dialysis
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