The effects of stress, anxiety and depression on markers of peritoneal immune function in capd patients: An exploratory study

The purpose of this descriptive, correlational study was to explore the relationship between Stress. anxiety and depression and markers of peritoneal immune function in patients receiving Continuous Ambulatory Peritoneal Dialysis (CAPD). Thirty two subjects aged 30-77 years of whom 20 were male and 12 female and who were on CAPD for a mean of 25.3 months participated in the study. An overnight dialysis effluent exchange was used to measure peritoneal immune function. The markers were unstimulated (baseline) and stimulated (with phorbol ester) peritoneal cellular respiratory burst activity, number of peritoneal effluent macrophages, and effluent concentrations of PGE 2 and IgG. Stress was measured with the Dialysis Stressor Scale and the Daily Hassles Questionnaire. Anxiety was measured using the State Trait Anxiety Inventory while depression was measured with the Self-Rating Depression Scale. Significant positive correlations were found between stimulated and unstimulated respiratory burst activity and stress (r = 0.37−0.46), anxiety (r = 0.28−0.39) and depression (r = 0.40−0.47). However, when the alpha level was adjusted to protect against multiple testing, only the correlation between depression and stimulated respiratory burst activity was significant. The results imply a weak relationship between stress, anxiety and depression and peritoneal immune function. However these relationships might be obscured by their multifactorial nature and a low sample size. Those caring for CAPD patients should be alerted to the effects of psychological factors on their patients' immune function and consequently their resistance to infections such as peritonitis.