Anxiety and depression among renal transplantation candidates: impact of donor availability

Abstract

Background: Among the kidney transplantation candidates, rega rdless if they already have a living related donor (LRD) or if they are waiting for a cadaveric donor (CD), the transplantation process is highly stressful, and the stress intensity is proportioned to the waiting time for surgery. The patients waiting for a CD have no certainty about recieving a kidney in time for surviving, or, when the patient’s relatives refused the donation, they may feel rejected by their family. In chronic diseases, psychiatric comorbidity affects the disease evolution, dampering the treatment efficacy, leading to long-term hospitalizations and a more severe emotional stress.

Objective: To calculate the difference of anxiety and depression levels between LRD and CD patients.

Methods: The Hospital Anxiety and Depression scale (HAD) was applied to the kidney transplantation candidates who attended their first psychiatric evaluation along a year, they were grouped according to their kind of donor (LRD= 31, CD= 12). Statistical analysis was performed by means of Fisher and Mann-Whitney tests.

Results: 33.33% of the LRD atients were anxious (6.60± 2.65 points) and 40% were depressed (5.9± 3.29); 75% of the CD patients were anxious (p= 0.005) (10.17± 2.48, p< 0.001) and 90% were depressed (p= 0.088) (12.0± 9.33, p= 0.005).

Conclusions: The CD patients have a greater risk for anxiety and more severe depressive disprders than the LRD patients. Comparing this sample against 100 patients with chronic diseases, we found no differences with CD patients, but they have a higher risk for anxiety and depression than LRD patients, this may suggest that the last mentioned patients may overestimate the prognosis of their disease.