Abstract
Depression is the most common psychiatric condition in Chronic Kidney Disease (CKD), but there are few studies that analyzed this condition in patients in different phases of disease. This article aims to evaluated depression in CKD patients, comparing patients in different phases of disease. Methods: We evaluated 134 patients with CKD submitted to conservative ambulatory treatment, and 36 patients with end-stage renal disease undergoing hemodialysis (HD). To evaluate depression, we used the Beck Depression Inventory (BDI), and the Beck Depression Inventory—SF (BDI-SF), a subscale that allows evaluate only the cognitive aspects of depression. Functional capacity was evaluated using the Karnofsky Performance Scale, and clinical and sociodemographic variables were also investigated. Results: Using BDI, depression was identified in 37.3% of patients in conservative treatment and in 41.6% in HD patients (p > 0.05). This percentage reduced when the BDI-SF was used, to 11.1% in conservative CKD patients and 13.8% in HD patients (p > 0.05). Depression was associated with marital status, professional activity, income, comorbidities and functional capacity. Discussion: We observed high prevalence of depression in patients with CKD undergoing conservative or hemodialysis treatment. Depression was associated with some clinical and sociodemografic variables and with functional capacity.
Highlights
Chronic kidney disease (CKD) is determined by the presence of kidney injury and by the level of renal function, assessed according to the glomerular filtration rate
Average values obtained by the Beck Depression Inventory (BDI) and the Beck Depression Inventory Short Form (BDI-SF) scales were greater for patients undergoing hemodialysis compared to the group under conservative treatment; these differences were not statistically significant
Using a cut-off point of ≥14 for depression, the percentage of depressed patients was higher among those undergoing hemodialysis, both on the evaluation made by the BDI and the Beck Depression Inventory—SF (BDI-SF)
Summary
Chronic kidney disease (CKD) is determined by the presence of kidney injury and by the level of renal function, assessed according to the glomerular filtration rate. Depression is characterized as one of the most assessed psychological aspects regarding studies on patients with renal failure; there is a difficulty in recognizing its true extent in this population. This is due to methodological variations among studies (such as the diversity of instruments applied, which does not allow a comparison of results) and the difficulty of diagnosis generated by similarity of somatic symptoms present in depression and uremic symptoms, which leads to an increased number of false-positive cases (Kimmel, 2001, 2002; Kimmel et al, 2008; Kimmel & Peterson, 2006; Almeida & Meleiro, 2000; Zimmerman, Carvalho, & Mari, 2004)
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