Divsion of Nephrology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
CARIM School for Cardiovascular Diseases, University of Maastricht, Maastricht, The Netherlands.
J Nephrol. 2023 Sep;36(7):2037-2046. doi: 10.1007/s40620-023-01747-0. Epub 2023 Aug 22.
The mental health of dialysis patients during the COVID-19 pandemic may have been modulated by dialysis modality. Studies comparing mental health of in-center hemodialysis and peritoneal dialysis patients during the first 2 years of the pandemic are lacking.
We conducted repeated cross-sectional and multivariable regression analyses to compare the mental health of in-center hemodialysis and peritoneal dialysis patients from March 2019 until August 2021 using data from the Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes. The study period was divided into one pre-pandemic and six 3-month pandemic periods (period 1-period 6). Mental health was assessed with the Mental Component Summary score of the 12-item Short Form health survey and mental symptoms of the Dialysis Symptom Index.
We included 1274 patients (968 on in-center hemodialysis and 306 on peritoneal dialysis). Mental Component Summary scores did not differ between in-center hemodialysis and peritoneal dialysis patients. In contrast, in-center hemodialysis patients more often reported nervousness during period 3 (27% vs 15%, P = 0.04), irritability and anxiety during period 3 (31% vs 18%, P = 0.03, 26% vs. 9%, P = 0.002, respectively) and period 4 (34% vs 22%, P = 0.04, 22% vs 11%, P = 0.03, respectively), and sadness in period 4 (38% vs 26%, P = 0.04) and period 5 (37% vs 22%, P = 0.009). Dialysis modality was independently associated with mental symptoms.
In-center hemodialysis patients more often experienced mental symptoms compared to peritoneal dialysis patients from September 2020 to June 2021, which corresponds to the second lockdown of the COVID-19 pandemic. Mental health-related quality-of-life did not differ between in-center hemodialysis and peritoneal dialysis patients.
Netherlands Trial Register NL6519, date of registration: 22 August, 2017.
在 COVID-19 大流行期间，透析患者的心理健康可能受到透析方式的调节。目前缺乏比较大流行前 2 年期间中心血液透析和腹膜透析患者心理健康的研究。
我们使用荷兰 nOcturnal 和 hoME 透析研究改善临床结局的数据，对 2019 年 3 月至 2021 年 8 月期间的中心血液透析和腹膜透析患者进行了重复横断面和多变量回归分析。研究期间分为一个大流行前和六个为期 3 个月的大流行期（第 1 期至第 6 期）。使用 12 项简短健康调查的心理成分综合评分和透析症状指数的心理症状来评估心理健康。
我们纳入了 1274 名患者（968 名在中心血液透析，306 名腹膜透析）。中心血液透析和腹膜透析患者的心理成分综合评分无差异。相比之下，中心血液透析患者在第 3 期（27% vs 15%，P=0.04）、第 3 期（31% vs 18%，P=0.03；26% vs 9%，P=0.002）和第 4 期（34% vs 22%，P=0.04；22% vs 11%，P=0.03）更容易报告紧张不安，在第 4 期（38% vs 26%，P=0.04）和第 5 期（37% vs 22%，P=0.009）更容易感到悲伤。透析方式与心理症状独立相关。
与腹膜透析患者相比，从 2020 年 9 月至 2021 年 6 月，中心血液透析患者更常出现心理症状，这与 COVID-19 大流行的第二次封锁相对应。中心血液透析和腹膜透析患者的心理健康相关生活质量无差异。
荷兰试验登记处 NL6519，登记日期：2017 年 8 月 22 日。
