Association Between Anxiety and Depression With Dialysis Adequacy in Patients on Maintenance Hemodialysis

Abstract

BackgroundDepression and anxiety are common among hemodialysis patients and affect their treatment outcomes. Dialysis adequacy also affects the hemodialysis patients’ survival rates.ObjectivesThis study aimed to evaluate the correlation between anxiety and depression with dialysis adequacy.Patients and MethodsIn this cross-sectional study, 127 hemodialysis patients (73 males, 57.5%) with the mean age of 55.7 ± 17.5 were enrolled. Demographic and recent laboratory data were collected using self-administered questionnaires and by reviewing medical records. Dialysis adequacy measures including the Kt/V and urea reduction rate (URR) were calculated using standard formulas. The Hospital Anxiety and Depression Scale (HADS) was used to diagnose depression and anxiety. Independent sample t-test and Chi-square test were used to compare the values in different groups. Pearson correlations and linear regression were used to analyze the data using SPSS version 21.ResultsThe prevalence rates of depression and anxiety (HADS score ≥ 8) were 31.5% and 41.7%, respectively. The prevalence of both conditions was significantly higher in women than in men (P < 0.05). The mean values of Kt/V and URR were not different in patients with and without depression or anxiety. The anxiety scores were correlated with age (P = 0.007, r = -0.24) and parathyroid hormone (P = 0.04, r = -0.19). Younger age and lower parathyroid hormone were the only factors that predicted higher scores of anxiety in linear regression. The Kt/V or URR were not significantly correlated with depression and anxiety scores.ConclusionsDepression and anxiety are common among hemodialysis patients. There are no statistically significant correlation between depression and anxiety and dialysis adequacy.

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“…25,26 In keeping with previous reports, anxiety scores were greater for women than men, and more men generally reported more physical activity. 25,27 On the other hand, older age and increasing comorbidity were not associated with greater selfreported depression or worse quality of life. Previous reports have proposed that patient perception of illness and well-being have a greater effect than chronological age or comorbidity.…”

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“…Anxiety, depression, and suicidal ideation are prevalent among patients with ESRD, and are increased in proportion to the degree of renal failure . Psychological issues are associated with poor QoL, increased rate of hospital readmissions, and length of hospital stay . Consequences of hemodialysis, such as fatigue and loss of appetite, make it difficult to differentiate anxiety and depression from the physical effects of treatment .…”

“…issues are associated with poor QoL, 8 increased rate of hospital readmissions, and length of hospital stay. 9 Consequences of hemodialysis, such as fatigue and loss of appetite, make it difficult to differentiate anxiety and depression from the physical effects of treatment. 10 While anxiety and depression are common in hemodialysis patients, they often remain undiagnosed.…”

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