Depression in Chronic Kidney Disease and End-Stage Renal Disease: Similarities and Differences in Diagnosis, Epidemiology, and Management

Abstract

Depression is highly prevalent and is associated with poor quality of life and increased mortality among adults with chronic kidney disease (CKD), including those with end-stage renal disease (ESRD). However, there are several important differences in the diagnosis, epidemiology, and management of depression between patients with non−dialysis-dependent CKD and ESRD. Understanding these differences may lead to a better understanding of depression in these 2 distinct populations. First, diagnosing depression using self-reported questionnaires may be less accurate in patients with ESRD compared with CKD. Second, although the prevalence of interview-based depression is approximately 20% in both groups, the risk factors for depression may vary. Third, potential mechanisms of depression might also differ in CKD versus ESRD. Finally, considerations regarding the type and dose of antidepressant medications vary between CKD and ESRD. Future studies should further examine the mechanisms of depression in both groups, and test interventions to prevent and treat depression in these populations.

Depressive Symptoms in Dialysis: Prevalence and Relationship with Uremia-Related Biochemical Parameters

“…The high prevalence of positive screening for depressive symptoms in our cohort has proved to be similar to data reported in the literature [4][5]. Moreover, depression is a known independent risk factor for mortality, morbidity and hospitalization in CKD and dialysis [17][18].…”

“…Depression is the most common psychiatric disorder in patients with advanced chronic kidney disease (CKD) [1][2][3], with prevalence of major depressive disorder estimated between 22.8 and 39.3% [4][5]. Such a high prevalence contrasts with the 2-4% prevalence found in the community, the 5-10% prevalence in primary care populations and the 10-14% prevalence in medical inpatients [6].…”

Impaired mental health status in patients with chronic kidney disease is associated with estimated glomerular filtration rate decline

“…Patients with ESRD are at risk of depression; several studies showed 20–30% of maintenance haemodialysis patients had a kind or several kinds of depressive disorders as well as patients with pre‐dialysis CKD . Depressive disorders increase mortality and incidence of cardiovascular events in CKD patients with or without ESRD . In addition, the association between CKD progression and depressive disorders were reported .…”

The effect of the eye movement desensitization and reprocessing intervention on anxiety and depression among patients undergoing hemodialysis: A randomized controlled trial

“…Depression is associated with sorrow, helplessness, despair, guilt, sleep disturbances, decreased appetite, and sexual desire disorders . It can lead to the increase of inflammation responses, acceleration of atherosclerosis, and cardiovascular diseases . Untreated mental health illnesses in hemodialysis patients contribute to increased morbidity and mortality, reduced QoL and even suicide …”