Negative Emotions in End-Stage Renal Disease: Are Anxiety Symptoms Related to Levels of Circulating Catecholamines?

The purpose of this study was to assess depression and anxiety levels and possible correlations with levels of circulating catecholamines in maintenance hemodialysis (MHD) and Conservative care (CC) ERSD patients. Eighty ESRD patients, forty treated by MHD and forty by CC, were included in the study. Circulating catecholamines concentrations were measured; all subjects were assessed by Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety, Self-Rating Depression Scale, and Self-Rating Anxiety Scale. Statistical analysis showed significant differences in Noradrenaline (p < 0.0001), higher in the CC group, and Dopamine (p = 0.002), higher in MHD subjects. Moreover, significant differences were documented regarding the anxiety variables (HRSA: p = 0.007; SAS: p = 0.007), all higher in CC group; no significant differences were documented on depression variables. Finally, linear regression analysis indicated that only noradrenaline was a strongest predictor of anxiety (HRSA: p = 0.003; SAS: p < 0.0001). ESRD patients showed a heightened vulnerability to anxiety. Given the concerns with pharmacologic treatment of emotional disturbances in patients with ESRD, the priority should be given to psychological interventions and preventive approaches aimed to address the early appearance of anxiety symptoms.