Effects of hemodialysis shifts on patients' aggression, depression, and anxiety symptoms and their relationship with chronotype characteristics

This study investigated chronotype characteristics in 112 chronic kidney disease (CKD) patients undergoing hemodialysis, the alignment of dialysis timing with chronotype, and their effects on biological rhythms and psychological symptoms. Chronotype was assessed using the Morningness-Eveningness Questionnaire (MEQ), while biological rhythms, aggression, depression, and anxiety were evaluated using the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN), Buss-Perry Aggression Questionnaire (BPAQ), and Hospital Anxiety and Depression Scale (HADS). Most patients had a morning chronotype, with no significant link to dialysis timing (p = 0.664). Eveningness was associated with disrupted social rhythms (p = 0.004), irregular eating (p = 0.035), verbal aggression (p = 0.049), and higher depression and anxiety (p = 0.038). Morning-type patients on afternoon dialysis showed higher hostility. Aligning dialysis sessions with chronotype may support better psychological health, treatment adherence, and reduced aggression.