title: Depression, anxiety and health-related quality of life amongst patients who are starting dialysis treatment.
abstract: BACKGROUND
  Chronic kidney disease (CKD) has a severe impact on patients' health-related quality of life (HRQL). The start of renal replacement therapy (RRT) significantly influences psychological, physical and social aspects of life.
  
  
  OBJECTIVE
  To analyse the HRQL and psychological status (anxiety and depression) at the start of RRT.
  
  
  METHODS
  We undertook an observational descriptive cross-sectional study. A total of 152 patients starting RRT were recruited for the study. HRQL was measured by the Kidney Disease and Quality of Life Short Form questionnaire. Levels of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale questionnaire. Comorbidities and sociodemographic and clinical factors were also evaluated.
  
  
  RESULTS
  HRQL in patients with end-stage kidney disease (ESKD) is significantly affected by the initiation of RRT in all respects. States of anxiety and depression were present in 26.6% and 27% of patients, respectively. These states are significantly related to the emotional component of the quality of life.
  
  
  CONCLUSIONS
  The initiation of RRT has a strong impact on HRQL in comparison with a reference population and with other stages of CKD. The early detection of an altered psychological state is important, as this condition should be treated from the first stages of the disease, as it can significantly affect the subsequent development of RRT and the patient's quality of life.
authors.affiliation: Department of Nephrology, Carlos Haya Regional University Hospital and University of Málaga, Málaga, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Rebollo Rubio
authors.affiliation: Faculty of Health Sciences, University of Málaga, Málaga, Spain.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Morales Asencio
authors.affiliation: Fresenius Medical Care, Málaga, Spain.
authors.forename: Ma
authors.initials: M
authors.lastname: Eugenia Pons Raventos
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D006435:Renal Dialysis / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000523:psychology*; D017582:Renal Replacement Therapy / Q000009:adverse effects / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Anxiety; Depression; End-stage kidney disease; Health-related quality of life; Renal replacement therapy