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. 2012 Jan;27(1):299-303.
doi: 10.1093/ndt/gfr305. Epub 2011 May 30.

Event-related distress in kidney disease patients

Sarah Ramer  1 , Anne Germain, Sheena Dohar, Mark Unruh
Affiliations

Event-related distress in kidney disease patients

Sarah Ramer et al. Nephrol Dial Transplant. 2012 Jan.

Abstract

Background: Non-dialysis-dependent chronic kidney disease (CKD) and dialysis-dependent Stage 5 CKD (CKD5) are associated with a significant physical and psychosocial burden. Little is known, however, about the impact of stressful life events on CKD and CKD5 patients. This study aimed to determine the prevalence of stressful life events in CKD and CKD5 patients and identify the factors correlated with high levels of event-related distress.

Methods: This cross-sectional study's sample consisted of 181 patients (91 with non-dialysis-dependent CKD Stages 4 and 5, 90 with CKD5) who filled out the Impact of Event Scale (IES), which measures subjective distress related to stressful life events. Other measures included scores from the Medical Outcomes Study Short Form-36, Patient Health Questionnaire-9 (PHQ-9) and Dialysis Symptom Index (DSI).

Results: One hundred and three subjects reported stressors on the IES. Almost half the stressors (49.5%) related to personal health; the rest fell into other categories. There were significant differences between the no stressor, low event-related distress and high event-related distress groups in age (P < 0.001), PHQ-9 score (P < 0.001) and DSI score (P = 0.002). After adjustment, PHQ-9 score was associated with high event-related distress [odds ratio (OR) 1.20, 95% confidence interval (CI) 1.10-1.32], as was DSI score (OR 1.04, 95% CI 1.02-1.07) in a separate model.

Conclusions: Event-related distress is common in CKD and CKD5 patients. High event-related distress is associated with worse depressive symptoms and greater somatic and emotional symptom burden, even with adjustments for age and gender. The renal practitioner may need to address patients' event-related distress in order to provide optimal care.

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Figures

Fig. 1.
Fig. 1.
Mean age by event-related distress level n = 181; P < 0.001 in ANOVA; P < 0.05 for no stressor versus low event-related distress and no stressor versus high event-related distress.
Fig. 2.
Fig. 2.
Mean PHQ-9 score by event-related distress level n = 177; P < 0.001 in ANOVA; P < 0.05 for no stressor versus high event-related distress and low event-related distress versus high event-related distress.
Fig. 3.
Fig. 3.
Mean DSI score by event-related distress level n = 176; P = 0.002 in ANOVA; P < 0.05 for no stressor versus high event-related distress and low event-related distress versus high event-related distress.
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