Wang Xinyue, Hao Xinmei, Ma Mi, Jiang Wei, Li Baoshuang, Xu Yan, Sun Ping
School of Mental Health, Jining Medical University, Shandong, China.
Department 2 of Elderly, Qingdao Mental Health Center, Shandong, China.
Clin Kidney J. 2024 Mar 13;17(3):sfae055. doi: 10.1093/ckj/sfae055. eCollection 2024 Mar.
Our aim was to investigate the relationship between chronic kidney disease (CKD) duration and suicide risk among maintenance hemodialysis patients in China.
Patients with end-stage renal disease (ESRD) who received MHD were enrolled. The demographic and disease characteristics of MHD patients were collected using a self-designed basic information questionnaire. The Suicide Risk Assessment Scale was used to assess suicide risk.
A total of 543 (40.8%) patients had suicide risk with Nurses' Global Assessment Scale for Suicide Risk scores ranging from 1 to 19 points. After adjusting for age, gender, disease conditions and mental state, the odds ratios of different CKD duration for suicide risk were 1.00, 2.02, 3.03 and 2.71, respectively ( for trend <.001). There were significant interactions between CKD duration and ESRD duration in relation to suicide risk ( for interaction <.001). There were also interactions between CKD duration and hemodialysis treatment duration, and suicide risk ( for interaction = .01). Patients with ESRD duration of ≤28 months or hemodialysis treatment duration of ≤24 months had the highest risk of suicide when the duration of CKD was 63-94 months, about 2-10 times higher than the other time groups.
We found that CKD duration was associated with an increased risk of suicide in maintenance hemodialysis patients in China, independently of other risk factors. Early ESRD and maintenance hemodialysis were associated with suicide in CKD patients.
我们的目的是研究中国维持性血液透析患者的慢性肾脏病(CKD)病程与自杀风险之间的关系。
纳入接受维持性血液透析(MHD)的终末期肾病(ESRD)患者。使用自行设计的基本信息问卷收集MHD患者的人口统计学和疾病特征。采用自杀风险评估量表评估自杀风险。
共有543例(40.8%)患者存在自杀风险,护士自杀风险综合评估量表得分在1至19分之间。在调整年龄、性别、疾病状况和精神状态后,不同CKD病程的自杀风险优势比分别为1.00、2.02、3.03和2.71(趋势检验P<0.001)。CKD病程与ESRD病程在自杀风险方面存在显著交互作用(交互作用检验P<0.001)。CKD病程与血液透析治疗时长之间也存在交互作用以及自杀风险(交互作用检验P=0.01)。当CKD病程为63 - 94个月时,ESRD病程≤28个月或血液透析治疗时长≤24个月的患者自杀风险最高,约为其他时间段组的2 - 10倍。
我们发现,在中国维持性血液透析患者中,CKD病程与自杀风险增加相关,独立于其他风险因素。早期ESRD和维持性血液透析与CKD患者的自杀有关。