To the editor: Patient acceptance of chronic disease often involves adjustment problems and thus anxiety-depressive disorders in reaction to the new situation. These problems in turn can be aggravated by situations of physical dependency typically found in patients suffering from multiple disease processes.



Patients with chronic kidney disease subjected to dialysis moreover often experience insomnia, which reduces their quality of life and increases the mortality risk.1 Restless legs syndrome is common in uremic patients, and worsens

at night ¿ preventing adequate sleep and constituting a mortality risk factor.2 On the other hand, it is known that worsened quality of sleep during the first year on dialysis is associated with a shortened life expectancy.3



The use of benzodiazepines, which are the most widely used drugs for treating anxiety, is common in patients on

dialysis. Their use is associated with important patient mortality.4-5



The present study analyzes physical dependency, comorbidity, the frequency of anxiety-depressive disorders, and sleep disturbances, as well as psychotropic drug consumption (benzodiazepines, non-benzodiazepinic hypnotics and antidepressants) among all patients in our Peritoneal dialysis Unit.



To this effect, we analyzed all our patients included in the peritoneal dialysis program of our Unit, with determination of the Barthel index (dependency scale for basic daily life activities), the Charlson-Bedhu comorbidity

scale, and the Hamilton anxiety-depression scale. Prescribed treatment was reviewed to determine psychotropic drug consumption frequency.



There were 10 patients with a mean age of 56 ± 16 years (range 33-77). The mean duration of enrollment in the peritoneal dialysis program was 12.85 ± 12.14 months (range 1-36). Forty percent of the patients were on ambulatory continuous peritoneal dialysis and 60% on automated peritoneal dialysis. The mean modified Charlson comorbidity score was 5.5 ± 2.14 (range 4-11). According to the Barthel index, 10% of the patients showed severe dependency (35 points), 20% mild dependency (75 and 85 points), and the rest (70%) no dependency (100 points). The Hamilton anxiety-depression scale in turn indicated that 20% of the patients suffered anxiety (> 8 points), while 10% scored in the depression range (> 18 points). As regards insomnia, 50% had no sleeping difficulties. The remaining 50% tended to wake up at night, and 30% were unable to fall sleep again afterwards. Psychoactive drug consumption showed two patients to use benzodiazepines, one consumed zolpidem, one used antidepressants, and

another antidepressants and benzodiazepines.



It can be concluded that our patient population suffered medium-high morbidity. Most of the patients (70%) were

independent for activities of daily living. Thirty percent of our patients suffered some anxiety-depressive disorder.

Insomnia was found to be very common (50%). Finally, psychotropic drug use was quite common - 50% of our patients being shown to use some drug of this kind.