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Kidney Week

Abstract: PO0831

Anxiety, Comorbid Depression, and Dialysis Symptom Burden

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Cukor, Daniel, Rogosin Institute, New York, New York, United States
  • Donahue, Stephanie, Rogosin Institute, New York, New York, United States
  • Tummalapalli, Sri Lekha, Rogosin Institute, New York, New York, United States
  • Bohmart, Andrew, Rogosin Institute, New York, New York, United States
  • Silberzweig, Jeffrey I., Rogosin Institute, New York, New York, United States
Background

Anxiety is an understudied construct in patients with kidney failure. Its relationship to dialysis and patient reported outcomes, including symptom burden, is not well known. ‘Anxiety’ describes a category of diagnoses and it is unknown if its components of general worry, somatic anxiety, and anxiety sensitivity have differential relationships with outcomes. It is also not known if depressive affect moderates these relationships.

Methods

In this single center survey study, 100 participants completed an assessment of depressive affect (Patient Health Questionnaire-9, PHQ-9), worry (Generalized Anxiety Disorder-7, GAD-7), somatic anxiety (Beck Anxiety Inventory, BAI), anxiety sensitivity (Anxiety Sensitivity Index, ASI), and dialysis symptom burden (Dialysis Symptom index – DSI). Medical charts were extracted for demographic information, number of missed dialysis sessions in the past 30 days (not rescheduled or due to hospitalization), and average interdialytic weight gain over the past 3 dialysis treatments.

Results

The characteristics of the sample are found in the table below. People with elevated somatic anxiety (BAI >15) had significantly higher rates of depression, worry, anxiety sensitivity, and dialysis symptom burden (p<.001, all cases). In a predictive model of symptom burden, age, race, and gender were not associated with symptom burden, and only somatic anxiety remained significant once adjusting for depression. In the final model, depression accounted for 40% of the variance and somatic anxiety accounted for an additional 37%.

Conclusion

It appears that the impact on symptom burden of depression and worry/anxiety sensitivity overlap significantly, but somatic anxiety, commonly found in panic disorder, may be a unique contributor to excess symptom burden.

Values are expressed as mean (standard deviation) unless otherwise stated