Epidemiology Profile and Associated Factors of Depression in Chronic Kidney Disease Stage 3-5 and Chronic Haemodialysis Patients in Cameroon

Abstract

Background: Depression is reported to be frequent in patients with chronic kidney disease and end stage kidney in high income countries. Little is known about depression in low income area such as Sub-Saharan Africa. Objective: Describe the epidemiology and factors associated with depression in patients with chronic kidney disease and in chronic haemodialysis in Cameroon. Methodology: We conducted a cross sectional study for 3 months in 2 nephrology services. Patients older than 18 years with CKD stage 3-5 and those on chronic haemodialysis who accepted to participate in the study were included. Depression was diagnosed using Beck Depression Inventory – Short Form (BDI -SF). A cut-off score ≥ 8 was used to diagnose depression. Results: Of the 196 patients included, 69 patients had CKD patients and 127 were on maintenance haemodialysis. Overall, depression was found in 40% (n=78) participants. Depression was less frequent in patients with CKD stage 3-4 (26%, n=12) and those who initiated dialysis ≤ 6 months (27%, n=6). Single/widow, unemployment, chronic pain and negative feeling about socio-familial life were common among depressed participants. Absence of chronic pain (OR 0.41[0.19-0.88], p=0.022), been socially active (OR 0.35[0.16-0.8], p=0.012) and good relationship with the spouse (OR 0.25[0.06-0.95], p=0.042) were independent factors associated with depression. Conclusion: Depression in frequent is chronic kidney disease and haemodialysis patients in Cameroon, affecting 2 patients out 5. Socio-demographic factors seems to be the main contributors. Psychological support should be proposed to these patients, especially among those who should initiated dialysis and with long haemodialysis stay.