Prevalence of Depression, Anxiety and Insomnia in Chronic Kidney Disease Patients and their Co-Relation with the Demographic Variables

Abstract

Background: Chronic kidney disease (CKD) is an emerging health problem in both developed and developing countries. Depression, anxiety and sleep disturbances are highly prevalent in patients with chronic disease, but remain undertreated despite significant negative consequences on patients' health. Assessment of key components of mental health early in disease course will help to identify high risk subjects in whom modifying these predictors will help in providing active and healthy life in CKD patients. Methods: We did a cross sectional study in 200 patients of CKD stage III to V-D fulfilling the eligibility criteria who were on follow up in a single tertiary care center in the state of Haryana, India. We assessed the prevalence of anxiety, depression and insomnia and their correlation with demographic variables in these patients. The structured questionnaire used in this study gathered information on respondent demographic and disease characteristics, and information obtained from the HADS and PSQI questionnaire. Factors associated with anxiety, depression and insomnia were examined by a multiple logistic regression analysis. results: The prevalence of anxiety, depression and insomnia were found to be 71%, 69% and 86.5% respectively. As the CKD stage advanced, the prevalence as well as severity of these parameters increased. Anxiety, depression and sleep quality were found to be significantly correlated to unemployment, low income, low education, urban residence and presence of co-morbidities. The anxiety, depression and insomnia scores were found to have a strong negative correlation with eGFR, hemoglobin, serum calcium (p <0.01) and a positive correlation with TLC, blood urea, serum creatinine and serum phosphate (p <0.05). conclusion: We observed a high prevalence of anxiety, depression and insomnia in CKD patients. There is a need to develop strategies to accurately identify "high risk" subjects who may benefit from preventive measures before complications occur. By identifying CKD patients with high risk of developing these mental health related issues, healthcare provider may be better able to ensure the provision of appropriate rehabilitation to this population.

Quality of life of chronic kidney patients on hemodialysis and related factors

“…Regarding the indications of depression, more than half of the patients had symptoms, which is in line with the results of a study in India (26) . Depressive disorders in this population can be related to the worst clinical outcomes, comorbidities, complications of the disease and treatment, hospitalizations, increased length of hospital stay, abandonment of dialysis, mortality and reduced quality of life (9,27) .…”

Psychiatric comorbidity and quality of life in patients undergoing hemodialysis

“…Also, depression was more observed in unemployed patients either not working before dialysis or stopped working after dialysis. These results come in agreement with a study done by Aggarwal et al [22], which was a cross-sectional study done on 200 patients of CKD stage III to stage V with dialysis and revealed that depression was significantly correlated to unemployment and low education. On the other hand, our findings disagree with those of Kumar et al [17], who showed that there was no significant relationship between depression and educational level or occupational state.…”

Association of Insomnia in Patients with Chronic Kidney Disease on Maintenance Hemodialysis

“…Specifically, a worsening CKD is directly associated with worsened insomnia [6]. Furthermore, a descriptive study published by Aggarwal et al [7] observed insomnia among 60% of patients who underwent hemodialysis (HD), whereas other studies report the frequency of insomnia as 86.5% [8] and 45% [9].…”