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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR  
Year : 2013  |  Volume : 24  |  Issue : 6  |  Page : 1256-1257
Symptoms of anxiety among patients with chronic kidney disease in Sri Lanka


1 Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
2 University Medical Unit, National Hospital of Sri Lanka, Sri Lanka

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Date of Web Publication13-Nov-2013
 

How to cite this article:
Rodrigo C, de Silva A, Lanerolle R. Symptoms of anxiety among patients with chronic kidney disease in Sri Lanka. Saudi J Kidney Dis Transpl 2013;24:1256-7

How to cite this URL:
Rodrigo C, de Silva A, Lanerolle R. Symptoms of anxiety among patients with chronic kidney disease in Sri Lanka. Saudi J Kidney Dis Transpl [serial online] 2013 [cited 2021 Mar 7];24:1256-7. Available from: https://www.sjkdt.org/text.asp?2013/24/6/1256/121302
To the Editor,

The psychological morbidity of patients with chronic kidney disease (CKD) is less explored in Sri Lanka. We screened our CKD patients for symptoms of anxiety. This was a cross-sectional survey of 100 consequent CKD patients attending the nephrology and transplant clinic of the University Medical Clinic of the National Hospital of Sri Lanka. It is a tertiary care referral center for CKD patients in Sri Lanka. The anxiety screening was performed with a simple, self-administered 10-item validated anxiety screening tool. [1] Ethical clearance for the study was obtained from the ethics review board of the National Hospital of Sri Lanka.

The sample included 65 males and 35 females (age range: 15 - 73 years). The majority of the screened patients were positive for severe anxiety (52%), while 27% had moderate anxiety. Of the total sample, 48% of the male patients, 57% of the female patients, 54% of the patients over the age of 30 years, 45% of the patients without a permanent income, 62% of the patients with a permanent income, 52% of the patients in CKD stages 1, 2 and 3 and 51% of the patients in CKD stages 4 and 5 screened positive for severe anxiety. On univariate analysis, sex, stage of CKD, dependence on hemodialysis, duration of diagnosis of CKD or having an own source of income did not show any significant association with anxiety. However, being older than 30 years was significantly associated with a positive screening for anxiety (P <0.05).

Our study showed that a large percentage of CKD patients had symptoms of moderate to severe anxiety regardless of the subgroups studied (sex, age, having an income, stage of CKD, dependence on hemodialysis and duration since diagnosis). Symptoms of anxiety can be either predominantly psychological (fear, restlessness, obsessions, unjustifiable worries), physical (palpitations, tremors, diarrhea, sweating) or a mix of both. [2] It can be easily misunderstood for a physical ailment such as hypoglycemia, arrhythmias or ischemic heart disease that are also common among CKD patients. In addition, recurrent complaints from anxious patients might irritate doctors and strain the doctor-patient relationship. Increased psychiatric morbidity will also have an impact on the overall well-being of the individuals and their families. Therefore, identifying and treating anxiety in CKD patients is a timely concern. However, in this study, we have employed only a screening tool, and it is not diagnostic of a formal anxiety disorder. Still, based on these findings, we do recommend the following:

  1. Anxiety screening tools should be routinely used for patients with CKD, and those who test positive should be referred for formal psychiatric assessment.
  2. Healthcare workers caring for CKD patients should be conscious about the features of anxiety and should attempt to alleviate it by patient and family education plus reassurance. c) Healthcare workers should not hesitate to use anxiolytic agents when necessary. They should also have a basic understanding of the non-pharmacological measures of relieving anxiety, such as meditation and relaxation therapy.
Conflict of Interest: None

 
   References Top

1.All Psych online. Anxiety screening test. (Web page) 2011; Available from: http:// allpsych.com/ tests/diagnostic/anxiety.html. (Last accessed on October 23, 2011).  Back to cited text no. 1
    
2.Gelder M, Mayou R, Geddes H. Psychiatry. 2 nd ed. Oxford: Oxford University Press; 1999.  Back to cited text no. 2
    

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Correspondence Address:
Chaturaka Rodrigo
Department of Clinical Medicine, Faculty of Medicine, University of Colombo
Sri Lanka
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DOI: 10.4103/1319-2442.121302

PMID: 24231498

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