The Prevalence Of Anxiety And Depression In Patients With Multicenter Chronic Kidney Disease Stage 1-5 In Inner Mongolia Autonomous Region And Its Influencing Factors Were Analyzed And A Risk Prediction Model Was Established

Objective: Chronic kidney disease(CKD)is a global public health problem,and people with CKD have varying degrees of psychological disorders.Especially since 2019,the new crown epidemic has continued to break out,and the depression and anxiety of patients under the influence of the epidemic will further aggravate and may affect the course of the disease.At present,there are few cases of anxiety and depression related to CKD patients at home and abroad,and there is a lack of multi-center data studies,and there are few related predictive models.This experiment collected a total of 488 cases of multi-center data from Inner Mongolia Autonomous Region,studied the mental health status of patients with chronic renal failure,analyzed the incidence of anxiety and depression and related influencing factors,established a predictive model affecting anxiety and depression in patients with CKD,and provided theoretical basis and practical guidance for discovering the emotional changes of anxiety and depression in patients with chronic kidney disease and giving appropriate interventions.Method:1.A total of 488 patients with chronic kidney disease stage 1-5 were selected from November 2021 to November 2022 in the Department of Nephrology of the Affiliated Hospital of Inner Mongolia Medical University,the Department of Nephrology of the Inner Mongolia Autonomous Region People’s Hospital,the Department of Nephrology of Hohhot First Hospital,the Department of Nephrology of Inner Mongolia International Mongolian Medical Hospital,and the Department of Nephrology of Tongliao City Hospital,and were willing to accept this research.2.Inclusion criteria:(1)CKD patients older than 18years;(2)require consciousness;(3)No taking antipsychotic drugs,no serious diseases that significantly affect emotions;(4)Participate with the informed consent of the individual.3.Exclusion criteria:(1)acute decline in renal function;(2)hyperor hypothyroidism;(3)severe hypoglycemia;(4)diabetic ketoacidosis;(5)Other central nervous system related diseases;(6)tumors;(7)Previous history of other mental illnesses;(8)Those who do not agree to participate in this study.4.Survey tools: Hamilton Depression Scale(HAMD)(24 items),Hamilton Anxiety Scale(HAMA)(14 items),Anxiety Self-rating Scale(SAS),Depression Self-rating Scale(SDS)were assessed within 24 hours of patient admission.Outcome :1.CKD patients only have anxiety: the prevalence of anxiety in CKD patients is 26.6%,of which mild 18.6%,moderate 5.3%,severe 2.7%,univariate analysis results: age(P=0.007),education level(P=0.009),sleep disorder(P<0.001),research center(P=0.021),the difference was statistically significant.The results of multivariate logistic regression analysis showed that age(P=0.011),OR value >1,education level(P=0.032),OR value <1,sleep disorder(P<0.001),OR value >1,indicating that age,sleep disorder was a possible independent risk factor,and education level was a possible independent protective factor.2.Patients with CKD only have depressed mood: the prevalence of depression in patients with CKD is 50.4%,of which 24.0% are mild,19.5% are moderate,and 7% are severe.Univariate analysis results:stage of chronic kidney disease(P=0.004),education level(P=0.034),monthly income(P<0.001),sleep disorder(P<0.001),dialysis(P=0.012),serum phosphorus(P=0.003),the difference was statistically significant.The results of multivariate logistic regression analysis showed that the monthly income(P=0.002),the OR value was small <1,the sleep disorder(P was less than 0.001),and the OR value was >1,indicating that sleep disorder was a possible independent risk factor for CKD combined with depression,and a monthly income was a possible independent protective factor.3.Anxiety complicated with depressive mood in patients with CKD: The prevalence of anxiety complicated with depression in patients with CKD was 23.97%,and the results of univariate analysis showed that the stage of chronic kidney disease(P=0.034),age(P=0.045),education level(P=0.043),monthly income(P=0.026),sleep disorder(P <0.001),dialysis(P=0.006),research center(P=0.010),the difference was statistically significant.The results of multivariate logistic regression analysis showed that age(P=0.024),OR value >1,sleep disorder(P<0.001),OR value >1,which may be independent risk factors.4.Anxiety or depression in patients with CKD: The prevalence of anxiety or depression in patients with CKD was 53.07%,and the results of univariate analysis:age(P=0.047),education level(P=0.007),monthly income(P<0.001),sleep disorder(P<0.001),serum phosphorus(P=0.016),the difference was statistically significant.Multivariate regression analysis results: age(P=0.033),OR value>1,monthly income(P=0.004),OR value <1,sleep disorder(P<0.001),OR value >1,serum phosphorus(P=0.026),OR value >1,age,sleep disorder,serum phosphorus as possible independent risk factors,monthly income as possible independent protective factors.Conclusion:(1)The older the CKD patient,the more likely he is to suffer from anxiety and depression;(2)The worse the sleep quality of CKD patients,the more likely they are to suffer from anxiety and depression;(3)The higher the monthly income of CKD patients,the less likely they are to suffer from anxiety and depression,and conversely,the more likely they are to suffer from anxiety and depression;(4)The prevalence of anxiety or depression in CKD patients was significantly higher than that of anxiety combined with depression,anxiety alone,and depression alone;(5)The risk prediction model of anxiety and depression in CKD patients has certain reference value;(6)The correlation coefficient between anxiety score and depression score reached 0.789,which was relatively large and reached a significant level(P<0.05).