Emotional management and biological markers of dietetic regimen in chronic kidney disease patients

Carlo Lai, Paola Aceto, Massimiliano Luciani, Erika Fazzari, Valerio Cesari, Stella Luciano, Antonio Fortini, Desiderata Berloco, Francesco Canulla, Vincenzo Bruzzese, Silvia Lai, Carlo Lai, Paola Aceto, Massimiliano Luciani, Erika Fazzari, Valerio Cesari, Stella Luciano, Antonio Fortini, Desiderata Berloco, Francesco Canulla, Vincenzo Bruzzese, Silvia Lai

Abstract

The aim of the study was to investigate the association between psychological characteristics and biological markers of adherence in chronic kidney disease patients receiving conservative therapy, hemodialysis, peritoneal dialysis (PD), or kidney transplantation. Seventy-nine adult patients were asked to complete the following questionnaires: Toronto Alexithymia scale, Snaith-Hamilton Pleasure Scale, and Short Form Health Survey. Biological markers of adherence to treatment were measured. Peritoneal dialysis patients showed a lower capacity to feel pleasure from sensorial experience (p = .011) and a higher values of phosphorus compared to the other patients' groups (p = .0001). The inability to communicate emotions was negatively correlated with hemoglobin levels (r = -(0).69; p = .001) and positively correlated with phosphorus values in the PD patients (r = .45; p = .050). Findings showed higher psychological impairments and a lower adherence to the treatment in PD patients and suggest the implication of emotional competence in adherence to treatment.

Keywords: Hemodialysis; alexithymia; kidney disease; quality of life; renal failure.

References

    1. Schieppati A, Remuzzi G.. Chronic renal diseases as a public health problem: Epidemiology, social, and economic implications. Kidney Int Suppl. 2005;68:S7–S10.
    1. Christensen AJ, Ehlers SL.. Psychological factors in end-stage renal disease: An emerging context for behavioral medicine research. J Consult Clin Psychol. 2002;70:712–724.
    1. García-Llana H, Remor E, Selgas R.. Adherence to treatment, emotional state and quality of life in patients with end-stage renal disease undergoing dialysis. Psicothema. 2013;25:79–86.
    1. Merkus MP, Jager KJ, Dekker FW, Boeschoten EW, Stevens P, Krediet RT.. Quality of life in patients on chronic dialysis: Self-assessment 3 months after the start of treatment. The Necosad Study Group. Am J Kidney Dis. 1997;29:584–592.
    1. Calia R, Lai C, Aceto P, et al. . Preoperative psychological factors predicting graft rejection in patients undergoing kidney transplant: A pilot study. Transpl Proc. 2011;43:1006–1009.
    1. Calia R, Lai C, Aceto P, et al. . Emotional management and quality of life in mother living versus multi-organ donor renal transplant recipients. J Health Psychol. 2015. [Epub ahead of print]. doi: 10.1177/1359105315604378.
    1. Calia R, Lai C, Aceto P, et al. . Emotional self-efficacy and alexithymia may affect compliance, renal function and quality of life in kidney transplant recipients: Results from a preliminary cross-sectional study. Physiol Behav. 2015;142:152–154.
    1. Wu AW, Fink NE, Marsh-Manzi JV, et al. . Changes in quality of life during hemodialysis and peritoneal dialysis treatment: Generic and disease specific measures. J Am Soc Nephrol. 2004;15:743–753.
    1. Cameron JI, Whiteside C, Katz J, Devins GM.. Differences in quality of life across renal replacement therapies: A meta-analytic comparison. Am J Kidney Dis. 2000;35:629–637.
    1. Fukunishi I, Maeda K, Kubota M, Tomino Y.. Association of alexithymia with low utilization and perception on a measure of social support in patients on peritoneal dialysis. Psychol Rep. 1997;80:127–130.
    1. Kojima M, Hayano J, Suzuki S, et al. . Depression, alexithymia and long-term mortality in chronic hemodialysis patients. Psychother Psychosom. 2010;79:303–311.
    1. DiMatteo MR, Lepper HS, Croghan TW.. Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000;160:2101–2107.
    1. Griva K, Lai AY, Lim HA, Yu Z, Foo MW, Newman SP.. Non-adherence in patients on peritoneal dialysis: A systematic review. PLoS One. 2014;9:e89001.
    1. Ware JE Jr, Sherbourne CD.. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483.
    1. Snaith RP, Hamilton M, Morley S, Humayan A, Hargreaves D, Trigwell P.. A scale for the assessment of hedonic tone the Snaith–Hamilton Pleasure Scale. Br J Psychiatry. 1995;167:99–103.
    1. Parker JD, Taylor GJ, Bagby RM.. The 20-Item Toronto Alexithymia Scale. III. Reliability and factorial validity in a community population. J Psychosom Res. 2003;55:269–275.
    1. Levey AS, Inker LA, Coresh J.. GFR estimation: From physiology to public health. Am J Kidney Dis. 2014;63:820–834.
    1. Oreopoulos DG, Thodis E, Passadakis P, Vargemezis V.. Home dialysis as a first option: A new paradigm. Int Urol Nephrol. 2009;41:595–605.
    1. Theofilou P.Noncompliance with medical regimen in haemodialysis treatment: A case study. Case Rep Nephrol. 2011;2011:476038.
    1. Calia R, Lai C, Aceto P, et al. . Attachment style predict compliance, quality of life and renal function in adult patients after kidney transplant: Preliminary results. Ren Fail. 2015;37:678–680.
    1. Calia R, Lai C, Aceto P, et al. . Effects of switching from twice-daily to once-daily tacrolimus formulation on quality of life, anxiety, and transplant benefit perception after kidney transplantation. Transpl Proc. 2011;43:1020–1023.
    1. Eriksson D, Goldsmith D, Teitsson S, Jackson J, van Nooten F.. Cross-sectional survey in CKD patients across Europe describing the association between quality of life and anaemia. BMC Nephrol. 2016;17:97.
    1. Lai C, Aceto P, Luciani M, et al. . Externally oriented thinking predicts phosphorus levels in dialyzed patients. Transpl Proc. 2016;48:309–310.
    1. Zoccali C, Ruggenenti P, Perna A, et al. . Phosphate may promote CKD progression and attenuate renoprotective effect of ACE inhibition. J Am Soc Nephrol. 2011;22:1923–1930.
    1. Chang AR, Grams ME.. Serum phosphorus and mortality in the Third National Health and Nutrition Examination Survey (NHANES III): Effect modification by fasting. Am J Kidney Dis. 2014;64:567–573.
    1. Yamamoto KT, Robinson-Cohen C, de Oliveira MC, et al. . Dietary phosphorus is associated with greater left ventricular mass. Kidney Int. 2013;83:707–714.
    1. Newsome B, Ix JH, Tighiouart H, et al. . Effect of protein restriction on serum and urine phosphate in the modification of diet in renal disease (MDRD) study. Am J Kidney Dis. 2013;61:1045–1046.
    1. Patel SS, Peterson RA, Kimmel PL.. The impact of social support on end-stage renal disease. Semin Dial. 2005;18:98–102.
    1. Lam LW, Lee DT, Shiu AT.. The dynamic process of adherence to a renal therapeutic regimen: Perspectives of patients undergoing continuous ambulatory peritoneal dialysis. Int J Nurs Stud. 2014;51:908–916.
    1. Fukunishi I, Saito S, Ozaki S.. The influence of defense mechanisms on secondary alexithymia in hemodialysis patients. Psychother Psychosom. 1992;57:50–56.

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