ORIGINAL RESEARCH article
Front. Psychol.
Sec. Health Psychology
This article is part of the Research TopicEnhancing Psychological Resilience and Therapeutic Adherence in Organ TransplantationView all 8 articles
Comparative psychological well-being evaluation among CKD patients on conservative therapy, dialysis, or kidney transplantation: a cross-sectional study
Provisionally accepted
Patrizia Pignataro*
Simona Simone
M. DicarloF. CassoneG. CaggianoR. GuidoF. PianconeC. SivoA. DipalmaR. RussoM. Spilotros
Pasquale Ditonno
Silvia ColucciG. Colaianni
Paola Pontrelli
Maria Grano
L. Gesualdo- University of Bari Aldo Moro, Bari, Italy
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Background: Chronic kidney disease (CKD) has a significant impact on psychological well-being. Here, the psychological evaluation of patients with CKD undergoing replacement treatment (dialysis or kidney transplantation) and conservative therapy (preemptive patients, who are waiting list for kidney transplantation) therapy was analyzed. In addition, serum irisin levels, a protein displaying anxiolytic and antidepressant effects in mice, were measured in dialysis patients. Methods: dialysis (N=57), non-dialysis (preemptive, N=31) and kidney transplant patients (N= 33) were enrolled. All participants underwent psychometric tests including State-Trait Anxiety Inventory (STAI-Y 1 and 2 form), Psychological General Well-Being Index (PGWBI), Symptom Checklist-90-R (SCL-90-R), etc. Serum irisin levels in dialyzed patients were measured by ELISA assay. Results: Dialysis patient group scored worse on all tests performed than both preemptive and kidney transplant patients. Indeed, dialysis patients displayed the lowest PGWBI score, and higher scores of BDI, and STAY-1 and STAY-2, compared with preemptive and kidney transplant patients. We also found that about 40% of dialysis patients showed significant psychological distress with higher clinical attention values in the somatization, obsessive-compulsive, depression and anxiety domains assessed by SCL-90. Furthermore, the stratification of all patients into groups younger and older than 50 years showed that the older group of transplanted patients displayed better outcomes than the younger ones. Finally, stratification of dialysis patients according to irisin levels revealed that only those with higher serum irisin levels had better psychological conditions in tests. Conclusions: Kidney transplantation as well as conservative therapy were related to a lower prevalence of depressive symptoms and other psychological disorders than dialysis. Furthermore, all transplanted patients over 50 years of age showed better outcomes than the younger ones. However, dialyzed patients with high levels of circulating irisin displayed better psychological conditions. Overall, our findings supported the importance to provide timely access to transplantation and to improve psychological support for dialysis patients.
Keywords: Chronic Kidney Disease, Dialysis, irisin, Kidney transplant, psychological assessment
Received: 28 Oct 2025; Accepted: 03 Dec 2025.
Copyright: © 2025 Pignataro, Simone, Dicarlo, Cassone, Caggiano, Guido, Piancone, Sivo, Dipalma, Russo, Spilotros, Ditonno, Colucci, Colaianni, Pontrelli, Grano and Gesualdo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Patrizia Pignataro
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