La malattia renale cronica: qualità di vita, ansia e depressione in un gruppo di pazienti in fase pre-dialitica

Patients with chronic diseases frequently show a marked deterioration in their quality of life (QoL). This paper was aimed at investigating on both the prevalence of psychological disorders and the impact on QoL in patients with chronic renal failure. The survey was conducted on 155 patients, aged 77±11 years, 104/51 M/F, with renal failure on conservative treatment (stages IV-V) referring to Nephrology Unit in Mauriziano Hospital, Turin. 13 of them (8.4%) were aged 30-64 years, 63 (40.6%) were aged 65-79 years and 79 (51%) 80 years and older. Two validated questionnaires were administered, namely the SF-12 (general state of health) and the HADS (anxiety and depression). Sixty-five percent of patients believed to have a low QoL associated with health, finding difficulties in daily life activities. The prevalence of all psychologic disturbances was higher in females (p = 0.09) and in patients with more comorbidities (p = 0.05). Depression was more frequent in elderly (p = 0.05) and in females (p = 0.012). Among patients aged 80 years or over, we found a prevalence rate of 36% for anxiety and of 51% for depression. In all patients, anxiety and depression were strongly associated (p < 0.01). In conclusion, compared to the general population, patients with chronic renal failure have a higher rate of either anxiety or depression, or both, and present with lower QoL scores. Clinical teams dedicated to the management of chronic renal diseases should pursue an interdisciplinary approach to their patients, in order to provide them with a suitable monitoring of QoL and psychological support if needed.