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Abstract: SA-OR015

Disease-Specific Stress Experienced by Patients with CKD

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 307 CKD: Health Services, Disparities, Prevention


  • Wright Nunes, Julie A., University of Michigan Health System, Ann Arbor, Michigan, United States
  • Kerr, Eve, University of Michigan, Ann Arbor, Michigan, United States
  • Chen, Emily P, University of Michgan, Ann Arbor, Michigan, United States
  • Garg, Gunjan, University of Michigan, Ann Arbor, Michigan, United States
  • Fagerlin, Angela, University of Utah, Salt Lake City, Utah, United States

Increased psychological stress is independently associated with decreased social functioning, poor quality of life and morbidity. We developed a new scale to assess patient psychological stress about a chronic kidney disease (CKD) diagnosis and examined whether stress varies across different patient demographics.


Adults with CKD Stages 1-5 were enrolled to take a cross-sectional survey from April 2015-May 2016. Eight questions (stress scale) assessed how often patients thought about their CKD, had trouble sleeping because of it, and felt fearful and worried (scale 0="not at all" to 3="often"). We also asked patients to rank CKD importance compared to other conditions. An a priori model was used to examine for validity. Reliability was calculated using Cronbach’s alpha. Associations were examined using linear regression.


203 patients were enrolled with a mean (SD) age 59 (16) years; 49% were men, 78% Caucasian, 16% African American (AA), 5% other races, 73% had CKD Stage 3-5, 48% had an annual income < $50K, and 95% had ≥ H.S. education. Cronbach’s alpha was 0.89 (excellent reliability).
The mean (SD) of the 8-item scale was 1.1 (0.6), range 0.0 – 2.8. Sixty-seven percent ranked CKD as either very important or their top health priority. Age was negatively associated [β = -0.01 (CI -0.02, -0.005); p<0.01] and AA race positively associated [β=0.4 (0.1, 0.6); p<0.01] with CKD stress scores. In adjusted analysis, age remained independently and negatively associated with stress scores [β = -0.01 (-0.02, -0.001); p=0.03], while AA race and CKD stage trended towards a positive association [β=0.33 (-0.004, 0.7); p=0.05] and [β=0.2 (-0.02, 0.5); p=0.08], respectively.


Our scale exhibits excellent internal reliability and evidence of validity assessing disease-specific stress in patients with CKD. Despite the majority of patients ranking CKD as very important/top health priority, overall patients reported low stress about their diagnosis. African American race conferred more perceived stress related to CKD. Future education and awareness interventions must consider the impact that disease knowledge has on patient stress, in particular for African American patients--and integrate individualized psychosocial support for all patients into education programs.


  • NIDDK Support