Impact of anxiety symptoms on dialysis adherence and complication rates: A longitudinal observational study

Table 1 Baseline characteristics of the study participants

Characteristic	Value (n = 250)
Age, years (mean ± SD)	58.3 ± 14.7
Sex, n (%)
Male	142 (56.8)
Female	108 (43.2)
Dialysis modality, n (%)
Hemodialysis	187 (74.8)
Peritoneal dialysis	63 (25.2)
Dialysis vintage, months, median (IQR)	36 (18-72)
Primary cause of ESRD, n (%)
Diabetic nephropathy	95 (38.0)
Hypertensive nephrosclerosis	62 (24.8)
Glomerulonephritis	45 (18.0)
Polycystic kidney disease	23 (9.2)
Other/unknown	25 (10.0)
Comorbidities, n (%)
Diabetes mellitus	128 (51.2)
Hypertension	218 (87.2)
Cardiovascular disease	87 (34.8)
Baseline HADS-A score (mean ± SD)	6.8 ± 4.2
Clinically significant anxiety (HADS-A ≥ 8), n (%)	92 (36.8)

IQR: Interquartile range; ESRD: End-stage renal disease; HADS-A: Hospital Anxiety and Depression Scale-Anxiety subscale.

Table 2 Association between anxiety symptoms and dialysis adherence measures

Adherence measure	Effect size	95%CI	P value
Missed dialysis sessions (IRR)	1.32	1.18-1.47	< 0.001
Interdialytic weight gain (β)	0.24	0.15-0.33	< 0.001
Medication adherence (OR)	0.85	0.78-0.93	< 0.001

IRR: Incidence rate ratio; OR: Odds ratio; CI: Confidence interval.

Table 3 Complication rates in patients with and without clinically significant anxiety

Complication	Clinically significant anxiety	No clinically significant anxiety	HR (95%CI)	P value
Overall complications	0.89 per patient-year	0.53 per patient-year	1.68 (1.32-2.14)	< 0.001
Infections	0.42 per patient-year	0.23 per patient-year	1.89 (1.41-2.53)	< 0.001
Cardiovascular events	0.31 per patient-year	0.20 per patient-year	1.57 (1.18-2.09)	0.002
Hospitalization	0.89 per patient-year	0.63 per patient-year	1.45 (1.15-1.83)	0.002

HR: Hazard ratio; CI: Confidence interval.