Anxiety and depression in haemodialysis patients in relation to dialysis adequacy and nutritional status

Abstract

IntroductionAnxiety and depression are distinct clinical entities associated with mortality in haemodialysis (HD) patients.AimsThis study aims to identify the prevalence of anxiety and depression in HD patients and uncover the association of anxiety and depression in relation to the dialysis adequacy and nutritional status.ObjectiveThis would help reinforce early detection and treatment to improve quality of life and patient's outcome in HD treatment.MethodForty HD patients were assessed for anxiety and depression with the Generalised Anxiety Disorder Assessment (GAD-7 and Patient Health Questionaire [PHQ-9]). The scores of GAD-7 and PHQ-9 were correlated with the demographic, clinical and laboratory variables and nutritional status assessed by a dietician through the Subjective Global Assessment (SGA).ResultsOut of the 40 HD patients, 7 (17.5%) were anxious and 15 (37.5%) were depressed. Patients were more anxious and less depressed with better nutrition. They were less anxious and depressed with increasing albumin levels, Charlston comorbidity index based on combined condition and age-related score and Kt/V. The univariate logistic regression analysis showed only a significant inverse correlation between depression and albumin level (P = 0.041, OR = 0.88 [95% CI = 0.78 to 0.99]) and Kt/V (P = 0.054, OR = 0.03 [95% CI = 0.01 to 1.07]).ConclusionDepression is more prevalent than anxiety in HD patients. The risk of depression also increases with poorer dialysis adequacy and nutritional status. Thus, by improving dialysis adequacy and nutritional status, we can reduce the incidence of depression. However, a significant correlation cannot be drawn for anxiety.Disclosure of interestThe authors have not supplied their declaration of competing interest.