肾移植受者的心理社会和生活质量评估：聚焦焦虑、抑郁及临床相关因素。
Psychosocial and quality of life assessment in kidney transplant recipients: a focus on anxiety, depression, and clinical correlates.
作者信息
Nassar Mohammed Kamal, Nagy Eman, Elshial Mohamed Mohamed, Samy Mostafa Mahmoud, Eltamaly Mohamed Ali, Elfarahati Moustafa Nagi, Tharwat Samar
机构信息
Mansoura Nephrology and Dialysis Unit (MNDU), Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Faculty of Medicine, Mansoura University, Mansoura, Egypt.
出版信息
BMC Nephrol. 2025 Aug 29;26(1):501. doi: 10.1186/s12882-025-04418-3.
BACKGROUND
Kidney transplantation (KT) significantly improves survival and quality of life compared to dialysis, yet psychological disorders like anxiety and depression critically influence post-transplant outcomes.
OBJECTIVES
To evaluate the prevalence, clinical correlates, and health-related quality of life (HRQoL) impacts of anxiety and depression in Kidney transplant recipients.
METHODS
A cross-sectional study of 161 adult Kidney transplant recipients at a tertiary care center assessed psychosocial and clinical parameters using the Hospital Anxiety and Depression Scale (HADS) and Kidney Disease Quality of Life − 36 (KDQOL-36). Sociodemographic, clinical, and laboratory data were analyzed with multivariate regression identifying predictors.
RESULTS
Abnormal anxiety and depression were observed in 24.3% and 9.9% of kidney transplant recipients, respectively. Anxiety correlated with elevated serum creatinine ( = 0.164, = 0.039) and lower hemoglobin ( = -0.16, = 0.043), while depression linked to lower hemoglobin ( = -0.172, = 0.029) and longer transplant duration ( = 0.159, = 0.045). Female gender, physical inactivity, psychiatric history, and higher creatinine independently predicted anxiety (all < 0.05). Patients with abnormal anxiety or depression reported significantly poorer HRQoL, particularly in “burden of kidney disease” (65.17 ± 28.69) and mental health domains (44.85 ± 11.41).
CONCLUSION
Anxiety and depression are prevalent in Kidney transplant recipients and strongly associated with clinical markers and impaired HRQoL. Routine psychosocial screening and targeted interventions, addressing anemia, physical activity, and mental health—are essential to optimize post-transplant care. Integrating biopsychosocial models into clinical practice may enhance adherence, graft survival, and quality of life in this vulnerable population.
CLINICAL TRIAL NUMBER
Not Applicable.
背景
与透析相比，肾移植（KT）显著提高了生存率和生活质量，但焦虑和抑郁等心理障碍严重影响移植后的结果。
目的
评估肾移植受者焦虑和抑郁的患病率、临床相关性以及与健康相关的生活质量（HRQoL）影响。
方法
在一家三级医疗中心对161名成年肾移植受者进行横断面研究，使用医院焦虑和抑郁量表（HADS）和肾病生活质量-36（KDQOL-36）评估心理社会和临床参数。通过多变量回归分析社会人口统计学、临床和实验室数据以确定预测因素。
结果
分别有24.3%和9.9%的肾移植受者存在异常焦虑和抑郁。焦虑与血清肌酐升高（=0.164，=0.039）和血红蛋白降低（=-0.16，=0.043）相关，而抑郁与血红蛋白降低（=-0.172，=0.029）和移植时间延长（=0.159，=0.045）有关。女性、缺乏身体活动、精神病史和较高的肌酐水平独立预测焦虑（均<0.05）。存在异常焦虑或抑郁的患者报告的HRQoL明显较差，特别是在“肾病负担”（65.17±28.69）和心理健康领域（44.85±11.41）。
结论
焦虑和抑郁在肾移植受者中普遍存在，并且与临床指标和受损的HRQoL密切相关。常规的心理社会筛查和针对性干预，解决贫血、身体活动和心理健康问题，对于优化移植后护理至关重要。将生物心理社会模型纳入临床实践可能会提高这一脆弱人群的依从性、移植物存活率和生活质量。
临床试验编号
不适用。
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