Kidney Transplantation Is Superior to Hemodialysis and Peritoneal Dialysis in Terms of Cognitive Function, Anxiety, and Depression Symptoms in Chronic Kidney Disease.

BACKGROUND: Cognitive impairment, anxiety and depression are important problems for patients with chronic kidney failure. Cognitive impairment, anxiety, and depression may be related to various factors, such as complications of hemo/peritoneal dialysis, uremic encephalopathy, psychosocial burden of the disease, and various comorbidities in patients with chronic kidney failure. Successful kidney transplantation (KT) improves kidney, endocrine, metabolic, and vascular systems, mental functions, and the quality of life of the patients. METHODS: A total of 181 patients with chronic kidney failure were studied: 54 currently on hemodialysis, 58 on peritoneal dialysis, and 69 with KT. All participants were given a detailed sociodemographic form, including data about the reason of kidney failure, duration of treatment (hemodialysis, peritoneal dialysis, and KT), and comorbid illnesses. Participants were evaluated with the use of the Hospital Anxiety and Depression Scale (HADS) for evaluating depressive and anxiety symptoms and the Brief Cognitive State Examination (BCSE) for detecting possible cognitive impairment. RESULTS: Patients with KT had lower levels of anxiety and depression symptoms than patients with hemodialysis and peritoneal dialysis. The KT group scored better than the hemodialysis and peritoneal dialysis groups on the BCSE. The peritoneal dialysis group scored higher on the BCSE than the hemodialysis group. The hemodialysis group scored higher on the HADS than the peritoneal dialysis group. CONCLUSIONS: In this study it was found that KT patients have better cognitive and mood regulation outcomes than hemodialysis and peritoneal dialysis patients with chronic kidney failure. With this knowledge we suggest that patients with kidney failure should have KT for having better cognitive functions and mood state as soon as possible.

Psychological and emotional status, and caregiver burden in caregivers of patients with peritoneal dialysis compared with caregivers of patients with renal transplantation.

OBJECTIVES: We sought to examine the relationship between caregivers of continuous ambulatory peritoneal dialysis (CAPD) and of renal transplant (Tx) patients with regard to sleep quality, anxiety, depression, and overall burden. METHODS: This cross-sectional study of prevalent caregivers of CAPD patients and of renal Tx patients used a multidimensional instrument to assess the association of sleep quality, depression and anxiety symptoms, as well as burden using a Zarit Burden Interview. Among the 113 caregivers who participated in this study, 53 were in the Tx and 60 in the CAPD group. RESULTS: The overall mean age was 40.7 ± 13.6 years. The proportions of age, gender, income, and education level were similar between the 2 groups. Caregivers of peritoneal dialysis patients had significantly higher rates of anxiety and depression compared with the Tx group (P = .039 and P = .003, respectively). Good sleep quality rates for caregivers of Tx versus CAPD patients were 88.7% (n = 47) and 61.7% (n = 37), respectively. Poor sleep quality was significantly higher among caregivers of CAPD compared with those for Tx patients (P = .001). Caregiver burden scores were significantly higher in caregivers of CAPD patients compared with Tx patients (P < .001). Upon logistic regression analysis, caregivers of CAPD patients were 2.61 times (95% confidence interval, 1.03-6.59; P = .043) higher than the caregiver burden risk than those for Tx patients. CONCLUSIONS: This study indirectly indicated that renal Tx improves the life quality and decreases psychiatric symptoms among caregivers of ESRD patients.