High depression rates among pediatric renal replacement therapy patients: A cross‐sectional study

Abstract

Depression is common in pediatric chronic kidney disease (CKD) patients. Depression is associated with inferior long‐term outcomes. There is a paucity of studies that evaluate depression and possible associated factors in children and adolescents requiring renal replacement therapy (RRT). Cross‐sectional study using Children`s Depression Inventory in a cohort from a large urban center. Forty‐seven pediatric RRT patients (26 female, 12 peritoneal dialysis (PD), 17 hemodialysis (HD), 18 after successful kidney transplantation (KTX)) with a mean age at the time of assessment of 13.9 ± 2.3 years. Symptoms of depression were found in 30 (64%, 11KTX, 11HD, 8PD) patients. We found no association with age, sex, renal function, dialysis adequacy markers, anemia, electrolytes, socioeconomical status, IQ, educational status of the child including school attendance and distance from the house to the hospital among HD patients. Significant differences only applied for age at diagnosis of CKD, RRT vintage and deceased donor for KTX. The group with depression had a higher age at diagnosis of CKD and less time on RRT than the group without depression. There was also a high rate of depression in KTX patients. In this cohort, depression was a common comorbidity of RRT in children and adolescents with RRT and also for KTX patients, even though biomarkers of kidney function and time for RRT are much improved.

Transition of kidney care at 18: Challenges and practical solutions for India

“…These include cognitive deficits, learning disabilities, memory deficits, low self-esteem, poor self-body image due to short stature, high-risk behavior, anxiety, and depression, with the prevalence of depression reportedly as high as 10%–35%. [ 23 24 25 ] They not only have a lower intellectual and academic functioning compared to healthy peers, but also have poor social functioning which interferes with their coping skills. [ 26 27 ] Nonadherence is another primary concern, especially involving transplant recipients at the time of transfer and generally in all patients less than 25 years of age.…”

An Interdisciplinary Approach to Optimize the Care of Transitioning Adolescents and Young Adults with CKD

“…Anxiety and depression are highly prevalent among pediatric CKD patients and often are associated with a history of maternal depression and anxiety, sometimes even during pregnancy for prenatally diagnosed conditions [22]. Mood disorders can affect as many as 2/3 of patients, especially in families with lower socioeconomic status [22].…”

“…Anxiety and depression are highly prevalent among pediatric CKD patients and often are associated with a history of maternal depression and anxiety, sometimes even during pregnancy for prenatally diagnosed conditions [22]. Mood disorders can affect as many as 2/3 of patients, especially in families with lower socioeconomic status [22]. In the CKD cohort, >25% of the patients have internalizing problems, attention problems and poor adaptive skills, persistent hypertension-associated attention problems, and resulting behavioral symptoms [23].…”

“…Caregivers not only have to perform their parenting duties but also must promote healthy family environments to allow the adaptation and to reduce frustration, anxiety and grief as much as possible. Caregiver anxiety is a major contributor to depression of the pediatric CKD patient [22]. Additionally, challenges with parenting skills affect how pediatric CKD patients grow up [23].…”

Resilience: A Protective Factor from Depression and Anxiety in Mexican Dialysis Patients

“…Symptoms of depression have been reported in 25% to 56% of Mexican adult patients on dialysis [7,[27][28][29]. Similarly, moderate to severe symptoms of depression have been found in Mexican children and adolescents on RRT [30]. The study of resilience in the renal population has shown that the construct is present in various dimensions in the life of the patient and has a mediating effect in relation to other psychological and contextual variables [21,23].…”