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. 2023 Sep;36(7):2037-2046.
doi: 10.1007/s40620-023-01747-0. Epub 2023 Aug 22.

Differences in mental health status during the COVID-19 pandemic between patients undergoing in-center hemodialysis and peritoneal dialysis

Pim Bouwmans  1   2 , Zeinab Skalli  3 , Robin W M Vernooij  3   4 , Marc H Hemmelder  1   2 , Wanda S Konijn  5 , Joy Lips  6 , Janneke Mulder  7 , Anna A Bonenkamp  8 , Brigit C van Jaarsveld  8   9   10 , Alferso C Abrahams  11 ; DOMESTICO study group
Collaborators, Affiliations

Differences in mental health status during the COVID-19 pandemic between patients undergoing in-center hemodialysis and peritoneal dialysis

Pim Bouwmans et al. J Nephrol. 2023 Sep.

Abstract

Background: The mental health of dialysis patients during the COVID-19 pandemic may have been modulated by dialysis modality. Studies comparing mental health of in-center hemodialysis and peritoneal dialysis patients during the first 2 years of the pandemic are lacking.

Methods: We conducted repeated cross-sectional and multivariable regression analyses to compare the mental health of in-center hemodialysis and peritoneal dialysis patients from March 2019 until August 2021 using data from the Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes. The study period was divided into one pre-pandemic and six 3-month pandemic periods (period 1-period 6). Mental health was assessed with the Mental Component Summary score of the 12-item Short Form health survey and mental symptoms of the Dialysis Symptom Index.

Results: We included 1274 patients (968 on in-center hemodialysis and 306 on peritoneal dialysis). Mental Component Summary scores did not differ between in-center hemodialysis and peritoneal dialysis patients. In contrast, in-center hemodialysis patients more often reported nervousness during period 3 (27% vs 15%, P = 0.04), irritability and anxiety during period 3 (31% vs 18%, P = 0.03, 26% vs. 9%, P = 0.002, respectively) and period 4 (34% vs 22%, P = 0.04, 22% vs 11%, P = 0.03, respectively), and sadness in period 4 (38% vs 26%, P = 0.04) and period 5 (37% vs 22%, P = 0.009). Dialysis modality was independently associated with mental symptoms.

Conclusions: In-center hemodialysis patients more often experienced mental symptoms compared to peritoneal dialysis patients from September 2020 to June 2021, which corresponds to the second lockdown of the COVID-19 pandemic. Mental health-related quality-of-life did not differ between in-center hemodialysis and peritoneal dialysis patients.

Trial registration number: Netherlands Trial Register NL6519, date of registration: 22 August, 2017.

Keywords: COVID-19; Cohort study; Hemodialysis; Pandemic; Peritoneal dialysis; Quality of life.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Overview of study periods in relation to restrictions and relaxations during the COVID-19 pandemic in the Netherlands
Fig. 2
Fig. 2
Mental component summary score (A) and prevalence of mental symptoms (B) in dialysis patients before and during the COVID-19 pandemic
Fig. 3
Fig. 3
Prevalence of mental symptoms among ICHD and PD patients before and during the COVID-19 pandemic
Fig. 4
Fig. 4
Adjusted Odds Ratios for mental symptoms of in-center hemodialysis and peritoneal dialysis patients before and during the COVID-19 pandemic. Adjusted for age, sex, psychiatric treatment, acute start dialysis, living situation and employment status
See this image and copyright information in PMC

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