Depression in dialysis

Abstract

Purpose of review The aim of this study was to examine updated prevalence rates, risk factors and the prognosis, diagnosis and treatments for depression among dialysis patients. Recent findings Depression influences prognosis, complications, quality of life (QOL), treatment and costs for dialysis patients worldwide. Reported prevalence of depression is 13.1–76.3%; it is higher for dialysis than transplant and higher post than predialysis. Reported depression rates with peritoneal dialysis (PD) compared with in-centre haemodialysis (HD) are inconsistent. Related medical factors are known, but suspected associated patient characteristics including gender and race remain unexplored. Associations between depression in dialysis and QOL, mortality, pathophysiological mechanisms of increased mortality, infection and pathways of inflammation-mediated and psychosocial factors require clarification. Several depression screening instruments are validated for dialysis patients – the Structured Clinical Interview for DSM disorders (SCID) remains the gold standard – but authors suggest the diagnostic standard should be higher than for the general population. Short-term studies indicate nonpharmacological therapy achieves clinical effects for depression in dialysis patients, but research on long-term effects is needed. Summary Depression management through early screening and continuous care models emphasizing dynamic relationships between healthcare teams, patients and families should be encouraged. Large-scale studies of short-term and long-term benefits of pharmacological and nonpharmacological depression management are warranted.

Relationship of life-satisfaction and self-efficacy with prognostic markers in patients undergoing hemodialysis: a cross-sectional study

“…Depression in incident hemodialysis patients was associated with a higher risk of hospitalization and longer hospital stay [18]. Depression in uences the prognosis, complications, quality of life, treatment and costs for dialysis patients worldwide [19]. Our cross-sectional study cannot prove a causal relationship between life-satisfaction scores and physical condition; however, it is meaningful to clarify the close relationship between mental and physical conditions in patients undergoing hemodialysis.…”

Relationship of life-satisfaction and self-efficacy with prognostic markers in patients receiving hemodialysis

“…Depressive affect in incident hemodialysis patients was associated with higher risk of hospitalization and more hospital days [18]. Depression in uences prognosis, complications, quality of life, treatment and costs for dialysis patients worldwide [19]. Our cross-sectional study cannot prove a causal relationship between life-satisfaction scores and health status, but it is meaningful to clarify the close relationship between mental and physical conditions in patients receiving hemodialysis.…”

Comparison of quality of life in patients with advanced chronic kidney disease undergoing haemodialysis, peritoneal dialysis and conservative management in Johannesburg, South Africa: a cross-sectional, descriptive study

“…In South Africa, where resource constraints restrict patient choice of dialysis modality, this reported benefit of PD is often used to justify the institution of “PD-first” programmes. Actual evidence for any difference in mental health and quality of life between dialysis modalities depends on few studies with contradictory findings [ 17 , 25 , 26 ].…”