Psychological review of hemodialysis patients and kidney transplant recipients during the COVID-19 pandemic

Table 1 Sociodemographic and clinical data

Characteristic	HD group, n = 89	KT group, n = 36	P value
Age in yr	54.75 ± 15.43	44.54 ± 9.93	< 0.001
Sex
Male	42	22	0.225
Female	47	14
Occupational status
Permanent job	7	8	0.101
Temporary job	5	2
Unemployed	77	26
Marital status
Single	40	12	0.321
Married	49	24
Level of educational
Low	36	2	< 0.001
Middle	42	14
High	11	20
Social network
Support available	69	22	0.1
Not available	20	14
Smoking	14	5	0.999
Alcohol consumption	2	1	0.999
Comorbidities	68	20	0.028
ESRD duration in yr	8.9 ± 7.23	15.2 ± 6.4	< 0.001
Transplant follow-up in yr	-	8.23 ± 5.15	-
Creatinine in mg/dL	8.64 ± 1.36	1.37 ± 0.52	< 0.001
Urea in mg/dL	212.72 ± 71.13	45.1 ± 18.83	< 0.001
Albumin in g/L	4.17 ± 0.36	4.43 ± 0.31	< 0.001
Phosphorus in mg/dL	5.29 ± 1.38	3.38 ± 0.8	< 0.001
Parathyroid hormone in ng/L	690.63 ± 580.97	84.22 ± 58.65	< 0.001
Calcium in mg/dL	7.78 ± 0.83	9.38 ± 0.58	< 0.001
Hemoglobin in g/dL	10.43 ± 1.61	13.01 ± 2.02	< 0.001
Previous psychiatric diagnosis	21	10	0.794
Active psychiatric treatment	9	4	0.999
Non-compliance with treatment	5	20	< 0.001

ESRD: End-stage renal disease; HD: Hemodialysis; KT: Kidney transplantation.

Table 2 Patient concerns regarding the coronavirus disease 2019 pandemic

Concerns	Intensity	HD group, n	%	KT group, n	%	P value
Contracting COVID-19	None/very mild	9	10.1	7	19.4
	Mild	8	9.0	6	16.7	0.118
	Moderate/severe	72	80.9	23	63.9
Inability to access medical treatment	None/very mild	9	10.1	5	13.9
	Mild	9	10.1	8	22.2	0.125
	Moderate/severe	71	79.8	23	63.9
Loss of caregiver and social support	None/very mild	7	7.9	6	16.7
	Mild	7	7.9	2	5.6	0.337
	Moderate/severe	75	84.3	28	77.8
Financial hardship	None/very mild	3	3.4	6	16.7
	Mild	8	9.0	11	30.6	< 0.001
	Moderate/severe	78	87.6	19	52.8
Loneliness	None/very mild	9	10.1	14	38.9
	Mild	11	12.4	10	27.8	< 0.001
	Moderate/severe	69	77.5	12	33.3
Stigmatization	None/very mild	10	11.2	20	55.6
	Mild	7	7.9	3	8.3	< 0.001
	Moderate/severe	72	80.9	13	36.1
Limited access to health care services	None/very mild	8	9.0	8	22.2
	Mild	13	14.6	8	22.2	0.05
	Moderate/severe	68	76.4	20	55.6
Failure to find medical supplies	None/very mild	9	10.1	7	19.4
	Mild	11	12.4	14	38.9	< 0.001
	Moderate/severe	69	77.5	15	41.7
Transmission of COVID-19 to family and friends	None/very mild	2	2.2	7	19.4
	Mild	4	4.5	4	11.1	0.001
	Moderate/severe	83	93.3	25	69.4
Contracting COVID-19 from family and friends	None/very mild	2	2.2	3	8.3
	Mild	8	9.0	7	19.4	0.064
	Moderate/severe	79	88.8	26	72.2
Overall perceived stress score	None/very mild	3	3.4	6	16.7
	Mild	6	6.7	11	30.6	< 0.001
	Moderate/severe	80	89.9	19	52.8

COVID-19: Coronavirus disease 2019; HD: Hemodialysis; KT: Kidney transplantation.

Table 3 Scale scores

Scores	HD group, mean ± SD	KT group, mean ± SD	P value
HADS
Anxiety score	9.36 ± 4.38	6.89 ± 4.06	0.004
Depression score	8.78 ± 4.05	6.42 ± 4.26	0.004
IES-R
Re-experiencing score	13.70 ± 7.31	16.25 ± 6.07	0.066
Hyper-arousal score	9.44 ± 5.91	11.56 ± 4.41	0.031
Avoidance score	14.53 ± 6.38	18.94 ± 4.85	< 0.001
Total score	37.66 ± 18.50	46.75 ± 13.98	0.009
CD-RISC
Tenacity and personal competence score	33.72 ± 12.58	43.47 ± 11.39	< 0.001
Tolerance and negative affect score	11.45 ± 5.05	15.58 ± 4.95	< 0.001
Tendency towards spirituality score	10.28 ± 2.83	9.75 ± 2.90	0.347
Total score	55.39 ± 18.65	68.75 ± 17.39	< 0.001

CD-RISC: Connor-Davidson resilience scale; HADS: Hospital anxiety and depression scale; HD: Hemodialysis; IES-R: The impact of events scale-revised; KT: Kidney transplantation.