SUN-282 Assessment of Depression in Hemodialysis Patients

Abstract

Hemodialysis still represents the main mode for renal replacement therapy (RRT) for End Stage Renal Disease (ESRD) in Egypt. Patients on hemodialysis (HD) are thought to be highly susceptible to emotional problems because of the chronic stress related to disease burden, dietary restrictions, functional limitations, associated chronic illnesses, adverse effects of medications, in self-perception and fear of death. However, despite their frequency and importance, such conditions often go unnoticed, since all patients do not clearly manifest fully expressed symptoms. The study included 100 Patients from 3 dialysis units in Al-Gharbia Governorate undergoing HD for at least 3 months, the patients filled out the followings: Beck Depression Inventory (BDI); Mini-mental State Examination; Social Status Examination (SSE). Laboratory investigations were provided including: serum Hemoglobin, Serum Ferritin level, Serum iron level, Transferrin Saturation (TSAT %), Serum Albumin, Serum calcium, Serum Phosphate and Intact Parathyroid Hormone (iPTH); Dialysis dose was assessed based on a single pool Kt/V. Maintenance HD is associated with a high prevalence of depression(80%) were depressed, Accordingdemographic and dialysis-related characteristics of the study population the depressed patients were significantly older, had a significantly lower dialysis adequacy, significantly higher dialysis vintage. Also they have significantly lower anemic parameters (hemoglobin, serum ferritin and TSAT %) while they did not show significant difference as regarding sex, employment, marital status, comorbidities, dialysis type, dialysis shift and laboratory parameters ( serum calcium, serum phosphorus, iPTH and serum albumin ). Also there isno significant association between presence of depression and virology status, level of cognition and socioeconomic status. Maintenance HD is associated with a high prevalence of depression. Understanding the degree to which depression affects this large and growing population may help facilitate the implementation of symptom alleviating therapies to improve psychological and overall well-being, quality of life, and consequently, reduce morbidity and mortality risk in this population, and their treatment costs. Our results, thus, advocate for incorporating a routine assessment and, if necessary, treatment of depression into the standard care provided to HD patients.