Levels of Depression and Anxiety and the Body Image of Female Patients on Renal Replacement Therapy.

BACKGROUND: Chronic kidney disease is a severe condition that can affect different dimensions of the patients' wellbeing. The aim of this study was to determine the role of the treatment type on the patients' levels of depression and anxiety as well as on their body image. SUBJECTS AND METHODS: A cross-sectional study was conducted on 146 respondents divided into three groups, 53 treated by hemodialysis (HD), 53 treated by kidney transplantation (TX), and 90 controls. Body image scale, PHQ-9 and GAD-7 were used to assess the patients. RESULTS: There was no difference in BIS between the groups HD and TX, nor between the TX and their age-matched controls. The TX group had lower levels of depression when compared to the HD group, and their levels of depression were similar to those of controls. No significant differences in anxiety were observed between the groups. CONCLUSION: Since the levels of depression are higher in the HD group, special attention should be given to these patients. Higher levels of psychological well-being in the transplant group is an additional factor why transplantation is the preferred method of treatment of CKD.

Alexithymia, Phosphorus Levels, and Sleep Disorders in Patients on Hemodialysis.

Alexithymia, or the inability to distinguish between bodily feelings and emotions, has been linked to poor sleep quality in some studies. Rare studies examined the associations between electrolyte phosphorus in patients on hemodialysis and their sleep quality, daytime sleepiness, and alexithymia with inflammatory factors. Hemodialysis is a treatment method for terminal renal patients that involves the diffusion of unwanted metabolic products through the dialyzer membrane. Our study aimed to examine whether there was a difference in phosphorus levels, inflammatory factors, and daytime sleepiness according to the hemodialysis patients' levels of alexithymia. The study involved 170 HD patients that had been treated with chronic dialysis for more than three months. Prior to the hemodialysis procedure, laboratory findings were sampled. Respondents completed the Pittsburgh Sleep Quality Index, the Toronto Alexithymia Scale 26, and the Epworth Sleepiness Scale, and were questioned about depression. The results showed that alexithymic HD patients exhibited significantly higher leukocyte counts, lower predialysis phosphorus values, and more pronounced daily sleepiness than the alexithymia-free group (Mann−Whitney U test, p = 0.02, p = 0.005, and p < 0.001, respectively). We concluded that alexithymia was an independent predictor of high daytime sleepiness in HD patients (OR = 1.05, 95% CI 1.02 to 1.09).

Sexual function in hemodialysis and post-renal transplant women in a relationship: a cross-sectional study.

PURPOSE: Difficulties in sexual functioning are very frequent in patients with chronic kidney disease (CKD). Sexual dysfunction (SD) can significantly diminish the quality of life (QOL) of affected individuals. The aim of this study was to determine the prevalence of SD in female patients undergoing chronic hemodialysis (CHD) and after renal transplantation (RTx) and to compare these groups with each other and with healthy control. METHODS: The survey was conducted among 123 female participants in a relationship, 28 of them undergoing CHD, 39 after RTx, and 56 healthy women without CKD. For the assessment of the sexual function and comorbidities, the Female Sexual Function Index (FSFI) questionnaire and Ifudu Comorbidity Index were used, respectively. RESULTS: Median age of all female participants was 60 (50-68). The median age of female CHD patients was 66 (61.3-72.8), RTx patients 56 (48-61), and the control group 59.5 (47.5-67.75). Among all participants, CHD female patients had the lowest scores in all sexual functioning domains. Compared to their age-adjusted control group, CHD patients had lower scores in desire, orgasm, and FSFI full score, whereas RTx patients had lower total FSFI scores and scores in all domains except for desire compared to their controls. Women with lower education, in marriage, and with more comorbidities had lower scores in sexual function domains. CONCLUSION: Our study shows that SD in female patients undergoing CHD treatment or those after RTx is substantially higher than that in healthy women. We suggest that female patient treated for CKD should have proper care regarding their sexual health, and differences in demographic and medical factors should be taken into consideration during the treatment management.