A comparison of anxiety and depression between pre-dialysis chronic kidney disease patients and hemodialysis patients using hospital anxiety and depression scale.

Salman T. Shafi,Tahir Shafi

doi:10.12669/pjms.334.12656

Abstract

Objective:Tocompare frequency of anxiety and depression between pre-dialysis chronic kidney disease (CKD) and hemodialysis patients (ESRD) in Pakistan.Methods:This study was conducted in an out-patient department and hemodialysis unit of Sharif Medical City Hospital. Inclusion criteria included age above 18 years and a diagnosis of CKD including both pre-dialysis CKD and ESRD patients. Patients were screened for anxiety and depression using hospital anxiety and depression scale (HADS).Results:A total of 156 patients were included in the study. Out of these patients, 81 (51.9%) had ESRD and 75 (48.1%) had pre-dialysis CKD. Mean age of all patient was 47.3±18.3 years, 96 (61.5%) were males and 60 (38.5%) were females. Median duration of renal disease was 16 months (IQR 8-36 months). Anxiety and depression were present in 111 (71.2%) and 113 (72.4%) of all patients respectively. Moderate to severe anxiety and depression were present in 54 (34.6%) and 60 (38.5%) patients respectively. In multiple logistic regression model, after adjusting for other variables, ESRD vs. pre-dialysis CKD was significantly associated with moderate to severe depression (AOR 2.26 (1.1-5.1).Conclusion:Both anxiety and depression are common in pre-dialysis CKD and ESRD patients. Patients with ESRD have higher frequency of depression compared to pre-dialysis CKD patients.

Highlights

Chronic kidney disease (CKD) is a growing public health problem.[1]
We found that anxiety and depression were present in 71.2% and 72.4% of all CKD patients including patients on hemodialysis
Frequency of moderate to severe anxiety was similar in pre-dialysis CKD and End Stage Renal Disease on Hemodialysis (ESRD) patients, but ESRD patients have higher frequency of moderate to severe depression compared to pre-dialysis CKD patients after adjusting for other variables

Summary

INTRODUCTION

Chronic kidney disease (CKD) is a growing public health problem.[1]. Depression is common in patients with CKD and is associated with adverse outcomes.[2]. Tahir Shafi, 1-2: Department of Nephrology, Sharif Medical and Dental College, Sharif Medical City Road Jati Umra, Lahore, Pakistan. Though less studied compared to depression, anxiety is common in CKD patients.[9] Prevalence. Anxiety and Depression in CKD patients of anxiety has been found to be 21.1%-53.4% in hemodialysis and pre-dialysis CKD patients.[10,11,12,13] In local studies, anxiety was present in 34.9%-42.7% of hemodialysis patients.[6,7]. The local literature on frequency of anxiety and depression is mainly focused on hemodialysis patients. There is limited local data on comparison of both anxiety and depression between pre-dialysis CKD and hemodialysis patients. The objective of this study was to compare frequency of anxiety and depression between pre-dialysis CKD and ESRD patients

METHODS

RESULTS

DISCUSSION

14. Chapter 1