Prevalence and risk factors associated with Anxiety Symptoms and Disorders Among Chronic Kidney Disease patients – A Systematic Review and Meta-analysis of studies

Abstract

Background: Anxiety is associated with poor health outcomes among chronic kidney disease (CKD) patients. This review summarizes the prevalence and risk factors associated with anxiety symptoms and disorders among CKD patients. Methods: Articles evaluating the prevalence and risk factors associated with anxiety symptoms and disorders among CKD patients, as diagnosed via DSM 4th or 5th edition criteria, clinical interviews or validated questionnaires, were searched in Medline®, Embase®, PsychINFO® and CINAHL®. Using random-effects meta-analyses, prevalence of anxiety was estimated. A narrative review on the risk factors associated with anxiety was presented. Results From 4941 articles, 61 studies were included. Pooled prevalence of anxiety disorders (9 studies, n=1071) among CKD patients across studies was 18.9% while that of anxiety symptoms (52 studies, n=10,739) was 42.8%. Across continents, prevalence of anxiety symptoms was highest in Europe and Asia. Between pre-dialysis and dialysis patients, prevalence of anxiety symptoms was statistically comparable at 30.5% and 42.1% respectively. Most commonly studied risk factors associated with anxiety were female gender, increased age, concomitant depression, and increased comorbidities. Conclusion Given the high prevalence of anxiety disorders and symptoms, there is a need for developing clinical guidelines on anxiety screening among CKD patients, facilitating early identification of at-risk patients.

Factors affecting the levels of anxiety and depression among patients with end-stage renal disease undergoing hemodialysis

“…Regarding anxiety symptoms, studies reported conflicting results [ 25 ]. For example, consistent with the findings of the current study, Alfikrie and colleagues showed no significant relationship between the patient’s age and the level of anxiety among patients with ESRD (Alfikrie et al) [ 26 ].…”

“…For example, consistent with the findings of the current study, Alfikrie and colleagues showed no significant relationship between the patient’s age and the level of anxiety among patients with ESRD (Alfikrie et al) [ 26 ]. A systematic review conducted in 2020, which assessed the prevalence of anxiety symptoms among dialysis patients, showed that anxiety symptoms were associated with increased age [ 25 ].…”

Prevalence and risk factors associated with depressive symptoms among end-stage renal disease patients undergoing hemodialysis in Indian setting

“…33 Another noteworthy evidence from systematic review reported that the prevalence of depression and anxiety was 59.6% and 23.1%, respectively. 34 With the growing evidence indicating the relationship between depressive symptoms and hemodialysis, clinicians may consider screening of depressive symptoms and subsequent referral to the psychologist if necessary.…”