Psychological profiles of end-stage renal disease patients undergoing pre-transplant evaluation

Objective: to identify specific psychological characteristics of individuals with end-stage renal disease (ESRD) who are undergoing evaluation for inclusion on the kidney transplant waiting list, as well as those already on the list. Materials and methods. The study was based on the hypothesis that individuals with ESRD exhibit a correlation between family-related anxiety and psychological traits such as weak personal boundaries, depressive symptoms, and difficulty recognizing and expressing emotions. To test this hypothesis, the following validated instruments were employed: Karpov’s Reflexivity Diagnostic Method, Beck Depression Inventory (BDI), the Sovereignty of Psychological Space Questionnaire – 2010, Toronto Alexithymia Scale (TAS-20) and Family Anxiety Analysis Questionnaire (FAA). The study sample included 60 people aged 18 to 71 years. The main group consisted of 30 respondents diagnosed with kidney failure, while the control group included 30 ESRD-free individuals. Statistical analysis was conducted using SPSS Statistics version 27.0. Results. The study found that patients with ESRD exhibited reduced levels of reflexivity compared to the control group (p ≤ 0.01). However, no statistically significant differences were observed between the groups in terms of depression levels, personal boundary preservation, or the ability to identify and describe emotions (p > 0.05). ESRD patients reported lower levels of family-related anxiety than the healthy individuals (p ≤ 0.05). Correlation analysis revealed a significant positive relationship between depression and the difficulty in recognizing and identifying emotions among ESRD patients (R = 0.491, p ≤ 0.01), as well as between depression and levels of anxiety (R = 0.418, p ≤ 0.05) and psychological tension (R = 0.640, p ≤ 0.01). An inverse correlation was found between the ability to recognize internal states and make informed decisions, and the perceived sense of security within one’s physical and psychological space (R = –0.385, p ≤ 0.05). Additionally, a direct correlation was identified between the level of depression and the duration of hemodialysis treatment in the ESRD population. Conclusion. The findings underscore the importance of considering psychological factors in the pre-transplant assessment and preparation of patients with kidney failure. Incorporating psychological evaluation into the transplant protocol may enhance both surgical outcomes and long-term adaptation to post-transplant life.

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