Impact of anxiety symptoms on dialysis adherence and complication rates:A longitudinal observational study  

作　　者：Peng Huang Hai-Ting Huang Jing Ma Jun Pang Yu-Yuan Zhang Chun-Hui Ma Si-Dan Wang Xiong-Zhuang Liang Jie Wang 

机构地区：[1]Department of Nephrology,The Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi Zhuang Autonomous Region,China [2]Department of Psychiatry,The Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi Zhuang Autonomous Region,China [3]Kidney System,Key Laboratory of Medical Research Basic Guarantee for Immune-Related Diseases Research of Guangxi,Baise 533000,Guangxi Zhuang Autonomous Region,China

出　　处：《World Journal of Psychiatry》2024年第12期1918-1924,共7页世界精神病学杂志（英文）

基　　金：Supported by the Nature Science Foundation of Guangxi,No.2017JJA0384.

摘　　要：BACKGROUND Anxiety is a common psychological comorbidity in patients undergoing dialysis,yet its impact on treatment adherence and complication rates remains understudied.We designed a longitudinal observational study to investigate these relationships,based on the hypothesis that higher anxiety symptoms would be associated with increased complication rates and negatively associated with adherence to the dialysis regimen.AIM To investigate the relationship between anxiety symptoms,dialysis adherence,and complication rates in patients undergoing dialysis over a 24-month period.METHODS This observational study analyzed data from 250 adult patients who underwent hemodialysis or peritoneal dialysis at three Affiliated Hospitals of Youjiang Medical University for Nationalities over a period of 24 months.Anxiety symptoms were assessed using the Hospital Anxiety and Depression Scale-Anxiety subscale at baseline and every 6 months.Dialysis adherence was evaluated through attendance records,interdialytic weight gain,and patientreported medication adherence.We recorded complications(infections,cardiovascular events,and hospitalizations)and used mixed-effects models and survival analyses to infer associations between anxiety symptoms,adherence measures,and complication rates.RESULTS Higher anxiety symptoms were significantly associated with poorer dialysis adherence,including increased missed sessions[incidence rate ratio=1.32,95%confidence interval(CI):1.18-1.47,P<0.001],greater interdialytic weight gain(β=0.24,95%CI:0.15-0.33,P<0.001),and lower medication adherence(odds ratio=0.85,95%CI:0.78-0.93,P<0.001).Patients with clinically significant anxiety(Hospital Anxiety and Depression Scale-Anxiety subscale≥8)had a higher risk of complications[hazard ratio(HR)=1.68,95%CI:1.32-2.14,P<0.001],particularly infections(HR=1.89,95%CI:1.41-2.53,P<0.001)and cardiovascular events(HR=1.57,95%CI:1.18-2.09,P=0.002).The relationship between anxiety and complications was partially mediated by adherence measures.CONCLUSION Anxiety symptom

关 键 词：ANXIETY DIALYSIS ADHERENCE COMPLICATIONS End-stage renal disease 

分 类 号：R749.4[医药卫生—神经病学与精神病学]