title: Nephrology pre-dialysis care affects the psychological adjustment, not only blood pressure, anemia, and phosphorus control.
abstract: Several studies have suggested that pre-dialysis care is associated with clinical outcomes. However, little has been reported on the influence of pre-dialysis care on the psychological adjustment to dialysis. The purpose of this study was to evaluate the impact of pre-dialysis care on psychological adjustment to dialysis and clinical characteristics. In this cross-sectional study, we enrolled 52 patients who started hemodialysis at our hospital. They were divided into two groups according to the time of referral to our hospital: the early referral group (over 1 year prior to first dialysis: 19 patients, mean age 69.3 ± 11.1) and the late referral group (within 1 year prior to first dialysis: 33 patients, mean age 72.3 ± 8.9). We measured the clinical characteristics and evaluated the psychological adjustment to dialysis by Shontz's stage theory. Compared with the late referral group, the early referral group had a significantly better clinical characteristics concerning blood pressure (140.2 ± 23.7 vs. 156.9 ± 23.3 mmHg, P = 0.0150), hemoglobin (10.3 ± 1.5 vs. 9.4 ± 1.0 g/dL, P = 0.0078), and phosphorus (4.5 ± 1.5 vs. 5.5 ± 1.3 mg/dL, P = 0.0166). In addition, psychological adjustment to dialysis evaluated by Shontz's stage theory was significantly better in the early referral group (P = 0.017). Our results indicate that nephrology pre-dialysis care affects not only blood pressure, anemia, and phosphorus control but also the psychological adjustment to dialysis.
authors.affiliation: Division of Nephrology, Kidney Center and Blood Purification, Iizuka Hospital, Iizuka, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Furusho
authors.affiliation: Division of Nephrology, Kidney Center and Blood Purification, Iizuka Hospital, Iizuka, Japan.
authors.forename: Minami
authors.initials: M
authors.lastname: Kawazu
authors.affiliation: Division of Nephrology, Kidney Center and Blood Purification, Iizuka Hospital, Iizuka, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Division of Nephrology, Kidney Center and Blood Purification, Iizuka Hospital, Iizuka, Japan.
authors.forename: Emiko
authors.initials: E
authors.lastname: Kurachi
authors.affiliation: Division of Nephrology, Kidney Center and Blood Purification, Iizuka Hospital, Iizuka, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Nakashima
authors.affiliation: Division of Nephrology, Kidney Center and Blood Purification, Iizuka Hospital, Iizuka, Japan.
authors.forename: Rikako
authors.initials: R
authors.lastname: Sagara
authors.affiliation: Division of Nephrology, Kidney Center and Blood Purification, Iizuka Hospital, Iizuka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hara
authors.affiliation: Division of Nephrology, Kidney Center and Blood Purification, Iizuka Hospital, Iizuka, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Mukai
authors.affiliation: Division of Nephrology, Kidney Center and Blood Purification, Iizuka Hospital, Iizuka, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Miura
authors.affiliation: Division of Nephrology, Kidney Center and Blood Purification, Iizuka Hospital, Iizuka, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Sugawara
mesh_terms: D000368:Aged; D000740:Anemia / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D000066498:Emotional Adjustment / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009398:Nephrology / Q000379:methods*; D010758:Phosphorus / Q000378:metabolism*; D006435:Renal Dialysis / Q000379:methods*
chemical_list: D010758:Phosphorus
keywords: Pre-dialysis care; Shontz's stage theory; nephrology referral; psychological adjustment