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

Abstract

Background: Depression is the most common psychiatric disorder in long-term dialysis patients and a risk factor for morbidity and mortality. Although there is a relevance of the issue in the dialysis setting, we still know little about possible relationships between depression and uraemia-related biochemical abnormalities. Our aims were to evaluate (1) the prevalence of depression in our haemodialysis (HD) and peritoneal dialysis (PD) population using a validated and easy-to-implement screening tool and (2) the association between depression and the main uraemia-related clinical and biochemical parameter changes. Methods: In this monocentric cross-sectional study, all patients of our centre with at least 3 months of dialysis were screened by Patient Health Questionnaire-9 (PHQ-9), a self-administered depression-screening questionnaire validated in dialysis setting. The impact of depressive symptoms on daily life was also assessed. We then analysed relationships between the PHQ-9-derived depressive score, functional impairment score, demographic, clinical and laboratory variables. Results: In our cohort of 145 patients, depressive symptoms were found in 69 patients (46%). Stratifying for severity, mild, moderate and severe grade accounted for 31, 13 and 2% respectively. Depressive symptoms affected 36% of patients on PD versus 52% of patients on HD. Moreover, the PD patients had significantly less functional impairment derived from depressive symptoms than the HD patients. Simple and multiple regression analysis identified serum phosphorus as the only uraemia-related laboratory parameter that was high statistically associated with depressive score. Conclusions: Using a reliable, simple and fast tool, we found that depressive symptoms affect almost half of dialysis patients, particularly so the HD cohort. Severity of depressive symptoms seems related to serum levels of phosphorus possibly because depression affects compliance to therapy.

Association between Satisfaction with Dialysis Treatment and Quality of Life: A Cross-Sectional Study

“…Mean patient age was 67.7 ± 14.0 years, and 44 patients were female; 78.6% of the patients were on HD, 21.4% were on PD (Table 1), 36.9% of patients presented anxious mood, and 53.6% presented depressive mood. These data were consistent to those of a previous article from our center where another screening instrument was used [14].…”

Clinical Observation on the Nursing Effect of Mindfulness-Based Stress Reduction Combined with Solution-Focused Brief Therapy in Uremic Peritoneal Dialysis Patients and Influence on Nutritional Status

“…However, in uremia as a chronic disease, in the process of long-term acceptance of PD, there is not only long treatment cycle but also high economic costs. With the progress of treatment, uremia patients undergoing PD will inevitably experience a certain degree of discomfort, which aggravates the physical and psychological burden of patients and further aggravates the complications caused by the disease [ 5 ]. At the same time, the uremia patients who received PD had low confidence in maintenance treatment, and the degree of cooperation with medical staff is not high, and the quality of life and psychological state of the patients are significantly lower than the normal population.…”

<p>The prevalence of depression and the association between depression and kidney function and health-related quality of life in elderly patients with chronic kidney disease: a multicenter cross-sectional study</p>

“…Depression is a common and significant psychiatric disorder in ESRD patients. The reported prevalence of depression varies from 23% to 46% in patients with ESRD or in dialysis populations 11–13. Studies have shown the effect of depression on dialysis, mortality, hospitalization and quality of life in these patients 14–16.…”