#4650 EVALUATION OF PSYCHOLOGICAL SUPPORT IN HEMODIALYSIS AND PERITONEAL DIALYSIS PATIENTS
Authors: Marturano Davide , Manani Sabrina Milan , Virzi Grazia Maria , Gechelin Chiara , Tantillo Ilaria , Ronco Claudio , Zanella Monica 
Published: June 2023

Abstract

Background and Aims
Chronic kidney disease is one of the chronic diseases with the biggest social impact. The quality of life of the patients with chronic kidney disease stage V is strongly affected by the recommended therapies. The choice between hemodialysis, peritoneal dialysis, transplantation or conservative management of chronic kidney disease is shared between clinician and patient. Caring of chronic kidney disease and especially renal function replacement treatment involves a commitment to the patient and family tissue that have an important influence on patient anxiety. Such situation alters the State-Anxiety, that expresses a perception connected to a specific context and it overlaps with Trait-Anxiety, that evaluates relatively stable aspects of being prone to anxiety. Anxiety can be split into two components, State Anxiety, expressing a context-related feeling, and Trait Anxiety, expressing an intrinsic personality condition.
The aim of this study was to investigate the presence of anxiety in patients on hemodialysis and peritoneal dialysis and the benefit that psychological support (either in-person or on line) could produce in these populations.

Method
The study group enrolled 24 patients: 13 were under haemodialysis and 11 were peritoneal dialysis patients. All patients were older than 18 years old and were followed at the Nephrology Hospital San Bortolo in Vicenza. Patients underwent eight sessions of psychological support. The first and the eighth sessions have been held in-person, while the others either in-person or on-line according to the patients’ preference. Nephrologists select patients to be treated according to their needs of psychological support.
The State-Trait Anxiety Inventory (STAI), which evaluates Trait and State Anxiety, was submitted during the first and eighth sessions. Statistical analysis was performed by software SPSS.

Results
The two groups were homogeneous for age, sex and comorbidities. There was no significant difference in the components of Trait and State Anxiety between the two groups considered prior to psychological support therapy (P = .38 and P = .64, respectively). Trait and State Anxiety decreased significantly after treatment both in hemodialysis and peritoneal dialysis (both p&lt;0.001). Trait Anxiety had a greater decrease compared to State Anxiety in both groups. The decrease of Trait Anxiety was similar in the two groups (P = .31)(Fig. 1). The decrease of State Anxiety was bigger in patients on peritoneal dialysis compared to hemodialysis patients: these patients had a greater benefit from the psychological support (P = .05)(Fig. 1). Furthermore, there was no significant difference between patients supported by in-person or on-line treatments (P = .68).

Conclusion
Psychological support in patients with renal replacement treatment leads to a reduction in Trait Anxiety and State Anxiety, regardless if the replacement therapy is hemodialysis or peritoneal dialysis. This allows patients to better tolerate the burden that the disease entails and to improve compliance to treatment. Psychological support could also help physicians in order to obtain better results with a stronger therapeutic alliance.