Quality of life and psychosocial relationships in patients with chronic renal insufficiency

The goal of the present study was to assess the psychological functioning level and the relationship between psychosocial variables and psychological functioning and social support buffering effects among a population of outpatients with chronic renal insufficiency (CRI). The Beck Depression Inventory, Illness Effects Questionnaire, Multidimensional Scale of Social Support, and Satisfaction With Life Scale were administered to 50 patients with CRI. The patients' nephrologist provided a Karnofsky scale rating to assess physical functioning. Sample scores were also compared for descriptive purposes to a previously reported sample of patients with more advanced disease and chronic renal failure (CRF), and a population of patients who had just started hemodialysis therapy for end-stage renal disease (ESRD). Patients with CRI are minimally depressed and perceive few negative illness effects. Satisfaction with life and cognitive depression scores were similar among the patients with CRI, CRF, and ESRD. Within the CRI sample, perception of illness, depression, and quality of life were significantly intercorrelated, indicating an emerging pattern of negative psychological reactions among some patients. Level of perceived social support was not correlated with other study variables. The mean level of perceived social support was lower among patients with CRI than in patients with ESRD. We conclude that even though most adjustment variables are in normal ranges, higher negative perception of illness is associated with higher depression scores and lower quality of life, even at this early stage of CRI. Additionally, social support may play an important role for those individuals beginning to experience a decline in renal functioning. (Am J Kidney Dis 1998 Oct;32(4):557-66)