Prevalence of Depression Among Dialysis Patients in Iran: A Systematic Review and Meta-Analysis of Observational Studies

Abstract

Context: Depression is a common issue among patients with chronic kidney disease, particularly those undergoing hemodialysis, and it can significantly impact their quality of life, treatment adherence, and disease progression. Objectives: The purpose of this study was to determine the prevalence of depression among dialysis patients in Iran using the Beck Depression Inventory (BDI) questionnaire. Data Sources: This study was a systematic review and meta-analysis. Six databases and Google Scholar were searched to identify all publications on the prevalence of depression among Iranian dialysis patients up until April 19, 2024. The quality of the identified articles was assessed, and the heterogeneity of the studies was evaluated using the I² Index. Publication bias was assessed using Egger's regression test and Sensitivity Analysis. Additionally, a meta-regression model was employed to evaluate variables suspected of contributing to heterogeneity at the 0.05 significance level. In the end, 17 articles were analyzed using Comprehensive Meta-Analysis software (ver. 2.2.064). Results: The prevalence of depression among dialysis patients, after sensitivity analysis using the random-effects model, was estimated at 0.564 (95% Confidence Interval [CI]: 0.524 - 0.603). The highest prevalence rate was reported in the eastern region of Iran, at 0.705 (95% CI: 0.051 - 0.991). Sample size, year, and mean age were significantly associated with the prevalence of depression among dialysis patients (P < 0.05). Conclusions: Depression is highly prevalent among dialysis patients in Iran, with approximately half of them having experienced it. Therefore, policymakers and health system managers must take serious measures to address this significant issue.