Müller Helge H, Englbrecht Matthias, Wiesener Michael S, Titze Stephanie, Heller Katharina, Groemer Teja W, Schett Georg, Eckardt Kai-Uwe, Kornhuber Johannes, Maler Juan Manuel
Department of Psychiatry and Psychotherapy, Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
PLoS One. 2015 Nov 11;10(11):e0140706. doi: 10.1371/journal.pone.0140706. eCollection 2015.
Depression/anxiety, impaired Health-Related Quality of Life (HRQoL) and coping and resilience structures, are associated with increased mortality/poor outcome in chronic kidney disease (CKD) patients before (CKD/pre-KT) and after kidney (CKD-T) transplantation. Less is known about prevalence rates of psychiatric symptoms and impaired HRQoL of non-transplanted compared with transplanted patients.
In a cross-sectional study comparing 101 CKD/pre-KT patients with 151 cadaveric-transplanted (CKD-T) patients, we examined prevalence of depression/anxiety (HADS questionnaire) and coping, resilience and HRQoL (SF-12, Resilience-Scale and FKV-questionnaire).
The prevalence of both depressive and anxiety symptoms was not significantly different between different pre-/and CKD-T patient groups. In CKD-T no significant relations of coping strategies with kidney function were identified. Furthermore, the Resilience Scales for acceptance and competence did not suggest any differences between the CKD/pre-KT and CKD-T subgroup. In the CKD/pre-KT patients, significant correlations were identified between the acceptance subscale and partnership, as well as between the competence subscale and older age/partnership.
Both the CKD/pre-KT and CKD-T patients exhibited notable impairments in the HRQoL which which showed a comparable pattern of results. KT itself does not appear to be the main risk factor for the development of mental impairments.
抑郁/焦虑、健康相关生活质量(HRQoL)受损以及应对和恢复力结构,与慢性肾脏病(CKD)患者在肾移植前(CKD/肾移植前)和肾移植后(CKD-T)的死亡率增加/预后不良相关。与移植患者相比,非移植患者精神症状的患病率和HRQoL受损情况鲜为人知。
在一项横断面研究中,我们比较了101例CKD/肾移植前患者和151例尸体肾移植(CKD-T)患者,检查了抑郁/焦虑的患病率(采用医院焦虑抑郁量表问卷)以及应对、恢复力和HRQoL(采用简明健康调查量表-12、恢复力量表和FKV问卷)。
不同的CKD/肾移植前和CKD-T患者组之间,抑郁和焦虑症状的患病率没有显著差异。在CKD-T患者中,未发现应对策略与肾功能之间存在显著关系。此外,接受度和能力的恢复力量表在CKD/肾移植前和CKD-T亚组之间未显示出任何差异。在CKD/肾移植前患者中,接受度子量表与伴侣关系之间以及能力子量表与年龄较大/伴侣关系之间存在显著相关性。
CKD/肾移植前和CKD-T患者在HRQoL方面均表现出明显损害,且结果模式具有可比性。肾移植本身似乎不是精神损害发生的主要风险因素。