Depression and anxiety among patients undergoing dialysis and kidney transplantation : a cross-sectional study.

BACKGROUND: Depression and anxiety are the most prevalent psychological disorders among end-stage renal disease patients and are associated with various conditions that result in poorer health outcomes, e.g. reduced quality of life and survival. We aimed to investigate the prevalences of depression and anxiety among patients undergoing renal replacement therapy. DESIGN AND SETTING: Cross-sectional study in Belo Horizonte, Brazil. METHODS: Patients? depression and anxiety levels were assessed using the Beck Inventory. The independent variables were the 36-Item Short-Form Health Survey (SF-36), Charlson Comorbidity Index and Global Subjective Assessment, along with sociodemographic and clinical characteristics. RESULTS: 205 patients were included. Depression and anxiety symptoms were detected in 41.7% and 32.3% of dialysis patients and 13.3% and 20.3% of transplantation patients, respectively. Lower SF-36 mental summary scores were associated with depression among transplantation patients (odds ratio, OR: 0.923; 95% confidence interval, CI: 0.85-0.99; P = 0.03) and dialysis patients (OR: 0.882; 95% CI: 0.83-0.93; P ? 0.001). Physical component summary was associated with depression among dialysis patients (OR: 0.906; 95% CI: 0.85-0.96; P = 0.001). Loss of vascular access (OR: 3.672; 95% CI: 1.05-12.78; P = 0.04), comorbidities (OR: 1.578; 95% CI: 1.09-2.27; P = 0.01) and poorer SF-36 mental (OR: 0.928; 95% CI: 0.88-0.97; P = 0.002) and physical (OR: 0.943; 95% CI: 0.89-0.99; P = 0.03) summary scores were associated with anxiety among dialysis patients. CONCLUSIONS: Depression and anxiety symptoms occurred more frequently among patients undergoing dialysis. Quality of life, comorbidities and loss of vascular access were associated factors

Hepatitis C incidence in hemodialysis patients in Brazil from 2000 to 2003.

O estudo visou estimar a incid?ncia dos fatores associados ? soroconvers?o para o anti-HCV em pacientes em hemodi?lise no Sistema ?nico de Sa?de (SUS). Trata-se de um estudo prospectivo, n?o concorrente, utilizando dados de pacientes identificados por relacionamento determin?stico- probabil?stico nos registros dos sistemas de informa??o do SUS. Foram inclu?dos 47.079 pacientes que iniciaram em hemodi?lise no per?odo de 1o de janeiro de 2000 a 31 de dezembro de 2003, acompanhados at? a soroconvers?o ou o t?rmino do estudo em 2004. Nesta pesquisa, 3% dos pacientes em hemodi?lise apresentaram soroconvers?o para anti-HCV (incid?ncia de 1,7 soroconvers?o por 100 pacientes/ano). Maior risco de soroconvers?o para o anti-HCV foi associado com idade, glomerulonefrites, regi?o de resid?ncia, anti-HIV positivo e efeito da unidade de di?lise. A incid?ncia observada de soroconvers?o para anti-HCV foi semelhante ? registrada em alguns pa?ses desenvolvidos, destacando-se a evid?ncia de transmiss?o entre os pacientes em hemodi?lise

Modality transition on renal replacement therapy and quality of life of patients : a 10-year follow-up cohort study.

Purpose Despite advance in renal replacement therapy (RRT), patients with chronic end-stage renal disease (ESRD) face various limitations, and renal transplantation (Tx) is the treatment that impacts most on quality of life (QoL). This study aimed to assess changes in QoL in a cohort of ESRD dialysis patients. Methods Sociodemographic, clinical, nutritional, lifestyle, and QoL data were collected from 712 patients at baseline (time 1) and after 10 years of follow-up (time 2) for patients surviving. The QoL was assessed through the 36-Item Short Form Health Survey (SF-36) and the multiple linear regression model was used to analyze the factors associated with change in QoL. Results A total of 205 survivors were assessed and distributed into three groups according to current RRT (Dialysis?Dialysis, Dialysis?Tx, and Dialysis?Tx?Dialysis). At time 1, only age was significantly different among groups; at time 2, transplant patients sustained greater social participation, job retention, and improvement in SF-36 scores. The factors associated with change in QoL were more time on dialysis interfering negatively on physical functioning (p=0.002), role-physical limitations (p =0.002), general health (p =0.007), social functioning (p=0.02), role-emotional (p = 0.003), and physical components ( p =0.002); non-participation in social groups at times 1 and 2 reducing vitality (p=0.02) scores; and having work at time 2, increasing vitality (p=0.02) and mental health (p =0.02) scores. Conclusions QoL was shown to be dynamic throughout the years of RRT, transplantation being the treatment with more benefits to the ESRD. More time on dialysis and limited social and occupational routine were associated with a reduction in QoL