Impacts of mindfulness-based interventions in people undergoing hemodialysis: a systematic review

Bruno Nunes Razzera, Angélica Nickel Adamoli, Maitê Freitas Ranheiri, Margareth da Silva Oliveira, Ana Maria Pandolfo Feoli, Bruno Nunes Razzera, Angélica Nickel Adamoli, Maitê Freitas Ranheiri, Margareth da Silva Oliveira, Ana Maria Pandolfo Feoli

Abstract

Introduction: Chronic kidney disease (CKD) is a serious public health problem worldwide, leading to a series of physical and psychological comorbidities, in addition to costly treatments, lifestyle and dietary restrictions. There is evidence that mindfulness-based interventions (MBIs) offer complementary treatment for people with chronic illnesses, including CKD, with the aim of improving overall health, reducing side effects and treatment costs. This review aims to investigate the MBIs impact on people with CKD undergoing hemodialysis, and to identify the methodological quality of the current literature in order to support future studies.

Methods: We ran searches in five databases (MEDLINE via PubMed, PsycINFO, Embase, Web of Science and Scopus) in July 2020. The papers were selected and evaluated by two reviewers independently, using predefined criteria, including the Cochrane Group's risk of bias tool and its recommendations (CRD42020192936).

Results: Of the 175 studies found, 6 randomized controlled trials met the inclusion criteria, and ranged from 2014 to 2019. There were significant improvements in symptoms of anxiety, depression, self-efficacy, sleep quality, and quality of life (n=3) in the groups submitted to the intervention, in addition to physical measures such as blood pressure, heart rate and respiratory rate (n=1).

Conclusions: MBIs can offer a promising and safe complementary therapy for people with CKD undergoing hemodialysis, acting on quality of life and physical aspects of the disease.

Conflict of interest statement

Conflict of Interest: We declare that there is no conflict of interest, professional, financial and direct or indirect benefits accruing from the information contained in the manuscript.

Figures

Figure 1. PRISMA Flowchart Note.
Figure 1. PRISMA Flowchart Note.
MBI: Mindfulness-based intervention.
Figure 2. Assessment of the risk of…
Figure 2. Assessment of the risk of bias of the included studies
Note. A: Summary of risk of bias for each trial; B: Graph on each risk of bias presented as percentages across all included studies.

References

    1. Saran R, Robinson B, Abbott KC, Agodoa LYC, Albertus P, Ayanian J, et al. US Renal Data System 2016 annual data report: epidemiology of kidney disease in the United States. [2021 Apr 21];Am J Kidney Dis. 2017 Mar;69(Suppl 3):A7–A8. Internet. Available from: .
    1. Birmelé B, Le Gall A, Sautenet B, Aguerre C, Camus V. Clinical, sociodemographic, and psychological correlates of health-related quality of life in chronic hemodialysis patients. Psychosomatics. 2012 Jan;53(1):30–37. Internet.
    1. Weisbord SD, Fried LF, Arnold RM, Fine MJ, Levenson DJ, Peterson RA, et al. Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients. J Am Soc Nephrol. 2005 Aug;16(8):2487–2494. doi: 10.1681/ASN.2005020157.
    1. Perlman RL, Finkelstein FO, Liu L, Roys E, Kiser M, Eisele G, et al. Quality of life in chronic kidney disease (CKD): a cross-sectional analysis in the Renal Research Institute-CKD study. Am J Kidney Dis. 2005 Apr;45(4):658–666. Internet.
    1. Spiegel BMR, Melmed G, Robbins S, Esrailian E. Biomarkers and health-related quality of life in end-stage renal disease: a systematic review. Clin J Am Soc Nephrol. 2008 Nov;3(6):1759–1768. doi: 10.2215/CJN.00820208.
    1. Hackett ML, Jardine MJ. We Need to talk about depression and dialysis: but what questions should we ask, and does anyone know the answers? Clin J Am Soc Nephrol. 2017 Feb;12(2):222–224. doi: 10.2215/CJN.13031216.
    1. Cukor D, Coplan J, Brown C, Friedman S, Cromwell-Smith A, Peterson RA, et al. Depression and anxiety in urban hemodialysis patients. Clin J Am Soc Nephrol. 2007 May;2(3):484–490. doi: 10.2215/CJN.00040107.
    1. Kovacs AZ, Molnar MZ, Szeifert L, Ambrus C, Molnar-Varga M, Szentkiralyi A, et al. Sleep disorders, depressive symptoms and health-related quality of life--a cross-sectional comparison between kidney transplant recipients and waitlisted patients on maintenance dialysis. Nephrol Dial Transplant. 2011 Mar;26(3):1058–1065. doi: 10.1093/ndt/gfq476.
    1. García-Llana H, Remor E, Del Peso G, Selgas R. The role of depression, anxiety, stress and adherence to treatment in dialysis patients' health-related quality of life: a systematic review of the literature. Nefrología. 2014;34:637–657. doi: 10.3265/Nefrologia.pre2014.Jun.11959.
    1. Davison SN. Clinical pharmacology considerations in pain management in patients with advanced kidney failure. Clin J Am Soc Nephrol. 2019 Jun;14(6):917–931. doi: 10.2215/CJN.05180418.
    1. Loosman WL, Rottier MA, Honig A, Siegert CEH. Association of depressive and anxiety symptoms with adverse events in Dutch chronic kidney disease patients: a prospective cohort study. BMC Nephrol. 2015 Sep;16(1):155–155. Internet.
    1. Olagunju AT, Campbell EA, Adeyemi JD. Interplay of anxiety and depression with quality of life in endstage renal disease. Psychosomatics. 2015 Jan;56(1):67–77. Internet.
    1. Wyld M, Morton RL, Hayen A, Howard K, Webster AC. A systematic review and meta-analysis of utility-based quality of life in chronic kidney disease treatments. PLoS Med. 2012 Sep;9(9):e1001307.
    1. Weisbord SD, Mor MK, Sevick MA, Shields AM, Rollman BL, Palevsky PM, et al. Associations of depressive symptoms and pain with dialysis adherence, health resource utilization, and mortality in patients receiving chronic hemodialysis. Clin J Am Soc Nephrol. 2014 Sep;9(9):1594–1602. doi: 10.2215/CJN.00220114.
    1. Birdee GS, Phillips RS, Brown RS. Use of complementary and alternative medicine among patients with end-stage renal disease. [2021 Apr 21];Evid Based Complement Alternat Med. 2013 :654109–654109. Internet. Available from:
    1. Arjuna Rao AM, Phaneendra D, Pavani CD, Soundararajan P, Rani NV, Thennarasu P, et al. Usage of complementary and alternative medicine among patients with chronic kidney disease on maintenance hemodialysis. J Pharm Bioall Sci. 2016;8(1):52–57. Internet.
    1. Navarrete-Navarrete N, Peralta-Ramírez MI, Sabio-Sánchez JM, Coín MA, Robles-Ortega H, Hidalgo-Tenorio C, et al. Efficacy of cognitive behavioural therapy for the treatment of chronic stress in patients with lupus erythematosus: a randomized controlled trial. Psychother Psychosom. 2010;79(2):107–115. Internet.
    1. Ludwig DS. Mindfulness in Medicine. JAMA. 2008 Sep;300(11):1350–1352. doi: 10.1001/jama.300.11.1350.
    1. Hayes SC, Hofmann SG. The third wave of cognitive behavioral therapy and the rise of process-based care. World Psychiatry. 2017 Oct;16(3):245–246.
    1. Kabat-Zinn J. Stress reduction clinic u. full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. Worcester: University of Massachusetts/Delacorte Press; 1990. Internet.
    1. Bishop SR, Lau M, Shapiro S, Carlson L, Anderson ND, Carmody J, et al. Mindfulness: a proposed operational definition. Clin Psychol Sci Pract. 2006 May;11(3):230–241.
    1. Shapiro SL, Carlson LE, Astin JA, Freedman B. Mechanisms of mindfulness. J Clin Psychol. 2006 Mar;62(3):373–386.
    1. Bowen S, Witkiewitz K, Clifasefi SL, Grow J, Chawla N, Hsu SH, et al. Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders. JAMA Psychiatry. 2014 May;71(5):547–556. doi: 10.1001/jamapsychiatry.2013.4546.
    1. Goyal M, Singh S, Sibinga EMS, Gould NF, Rowland-Seymour A, Sharma R, et al. Meditation programs for psychological stress and well-being. JAMA Intern Med. 2014 Mar;174(3):357–368. doi: 10.1001/jamainternmed.2013.13018.
    1. Russell T. Mindfulness in motion: unlock the secrets of mindfulness in motion. London: Watkins Media Limited; 2015.
    1. Segal ZV, Williams JMG, Teasdale JD. Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: Guilford; 2002.
    1. Kabat-Zinn J. Mindfulness-based interventions in context: past, present, and future. Clin Psychol Sci Pract. 2003 May;10(2):144–156. doi: 10.1093/clipsy/bpg016.
    1. Merkes M. Mindfulness-based stress reduction for people with chronic diseases. Aust J Prim Health. 2010;16(3):200–210. Internet.
    1. Lauche R, Cramer H, Dobos G, Langhorst J, Schmidt S. A systematic review and meta-analysis of mindfulness-based stress reduction for the fibromyalgia syndrome. J Psychosom Res. 2013 Dec;75(6):500–510. Internet.
    1. Lakhan SE, Schofield KL. Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis. PLoS One. 2013 Aug;8(8):e71834.
    1. Hilton L, Hempel S, Ewing BA, Apaydin E, Xenakis L, Newberry S, et al. Mindfulness meditation for chronic pain: systematic review and meta-analysis. Ann Behav Med. 2017 Apr;51(2):199–213. Internet.
    1. Zou L, Zhang Y, Yang L, Loprinzi PD, Yeung AS, Kong J, et al. Are mindful exercises safe and beneficial for treating chronic lower back pain? A systematic review and meta-analysis of randomized controlled trials. J Clin Med. 2019 May;8(5):628–628. Internet.
    1. Zainal NZ, Booth S, Huppert FA. The efficacy of mindfulness-based stress reduction on mental health of breast cancer patients: a meta-analysis. Psychooncology. 2013 Jul;22(7):1457–1465.
    1. Cramer H, Lauche R, Paul A, Dobos G. Mindfulness-based stress reduction for breast cancer-a systematic review and meta-analysis. Curr Oncol. 2012 Sep;19(5):e343–e352. doi: 10.3747/co.19.1016.
    1. Simpson R, Booth J, Lawrence M, Byrne S, Mair F, Mercer S. Mindfulness based interventions in multiple sclerosis - a systematic review. BMC Neurol. 2014 Dec;14(1):15–15. Internet.
    1. Solati K, Mardani S, Ahmadi A, Danaei S. Effect of mindfulness-based cognitive therapy on quality of life and self-efficacy in dialysis patients. J Ren Inj Prev. 2019;8(1):28–33. Internet.
    1. Thomas Z, Novak M, Platas SGT, Gautier M, Holgin AP, Fox R, et al. Brief mindfulness meditation for depression and anxiety symptoms in patients undergoing hemodialysis. Clin J Am Soc Nephrol. 2017 Dec;12(12):2008–2015. doi: 10.2215/CJN.03900417.
    1. Gross CR, Reilly-Spong M, Park T, Zhao R, Gurvich OV, Ibrahim HN. Telephone-adapted mindfulness-based stress reduction (tMBSR) for patients awaiting kidney transplantation. Contemp Clin Trials. 2017 Jun;57:37–43. Internet.
    1. Park J, Lyles RH, Bauer-Wu S. Mindfulness meditation lowers muscle sympathetic nerve activity and blood pressure in African-American males with chronic kidney disease. Am J Physiol Integr Comp Physiol. 2014 Jul;307(1):R93–101.
    1. Bennett PN, Ngo T, Kalife C, Schiller B. Improving wellbeing in patients undergoing dialysis: can meditation help? Semin Dial. 2018 Jan;31(1):59–64.
    1. Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions. Chichester: John Wiley & Sons Ltd.; 2008. [2021 Apr 21]. Internet. .
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009 Oct;62(10):e1–34. Internet.
    1. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019 Aug;366:l4898–l4898.
    1. Nejad M, Shahgholian N, Samouei R. The effect of mindfulness program on general health of patients undergoing hemodialysis. [2021 Apr 21];J Educ Health Promot. 2018 Jun;7:74–74. Internet. Available from:
    1. Reilly-Spong M, Reibel D, Pearson T, Koppa P, Gross CR. Telephone-adapted mindfulness-based stress reduction (tMBSR) for patients awaiting kidney transplantation: Trial design, rationale and feasibility. Contemp Clin Trials. 2015 May;42:169–184. Internet.
    1. Chen S, Lin H, Atherton JJ, MacIsaac RJ, Wu C. Effect of a mindfulness programme for long‐term care residents with type 2 diabetes: a cluster randomised controlled trial measuring outcomes of glycaemic control, relocation stress and depression. Int J Older People Nurs. 2020 Sep;15(3):e12312.
    1. Gonzalez-Garcia M, Ferrer MJ, Borras X, Muñoz-Moreno JA, Miranda C, Puig J, et al. Effectiveness of mindfulness-based cognitive therapy on the quality of life, emotional status, and CD4 cell count of patients aging with HIV infection. AIDS Behav. 2014 Apr;18(4):676–685. Internet.
    1. Schoultz M, Atherton IM, Hubbard G, Watson AJ. The use of mindfulness-based cognitive therapy for improving quality of life for inflammatory bowel disease patients: study protocol for a pilot randomised controlled trial with embedded process evaluation. Trials. 2013 Dec;14(1):431–431. Internet.
    1. Hubbling A, Reilly-Spong M, Kreitzer MJ, Gross CR. How mindfulness changed my sleep: focus groups with chronic insomnia patients. BMC Complement Altern Med. 2014 Dec;14(1):50–50. Internet.
    1. Godfrin KA, Van Heeringen C. The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: a randomized controlled study. Behav Res Ther. 2010 Aug;48(8):738–746. Internet.
    1. Brown KW, Ryan RM, Creswell JD. Mindfulness: theoretical foundations and evidence for its salutary effects. Psychol Inq. 2007 Oct;18(4):211–237.
    1. Bucharles SGE, Wallbach KKS, Moraes TP, Pecoits-Filho R. Hypertension in patients on dialysis: diagnosis, mechanisms, and management. Braz J Nephrol. 2018 Nov;41(3):400–411. Internet.
    1. Oneda B, Ortega KC, Gusmão JL, Araújo TG, Mion D. Sympathetic nerve activity is decreased during device-guided slow breathing. Hypertens Res. 2010 Jun;33(7):708–712. Internet.
    1. Nidich SI, Rainforth MV, Haaga DAF, Hagelin J, Salerno JW, Travis F, et al. A randomized controlled trial on effects of the transcendental meditation program on blood pressure, psychological distress, and coping in young adults. Am J Hypertens. 2009 Dec;22(12):1326–1331. doi: 10.1038/ajh.2009.184.
    1. Manikonda JP, Störk S, Tögel S, Lobmüller A, Grünberg I, Bedel S, et al. Contemplative meditation reduces ambulatory blood pressure and stress-induced hypertension: a randomized pilot trial. J Hum Hypertens. 2008 Feb;22(2):138–140. Internet.
    1. Goldstein CM, Josephson R, Xie S, Hughes JW. Current perspectives on the use of meditation to reduce blood pressure. Int J Hypertens. 2012;2012:578397–578397. Internet.
    1. Malarkey WB, Jarjoura D, Klatt M. Workplace based mindfulness practice and inflammation: a randomized trial. Brain Behav Immun. 2013 Jan;27:145–154. Internet.
    1. Rosenkranz MA, Davidson RJ, MacCoon DG, Sheridan JF, Kalin NH, Lutz A. A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation. Brain Behav Immun. 2013 Jan;27:174–184. Internet.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera