Association between depression and hemodialysis in patients with chronic kidney disease.

Depression is the most common and serious psychiatric disorder that affects patients with chronic kidney disease and end-stage renal disease, and, has a significant impact on their quality of life. The aim of this study was to investigate and compare prevalence rates of depression among hemodialyzed patients, and non-dialyzed patients with a glomerular filtration rate<30 ml/min/1.73m2 receiving conservative treatment or following kidney transplantation. A total of 50 hemodialyzed and 50 non-dialyzed patients with stage 4/5 of CKD was assessed using the following questionnaires: Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), The Satisfaction with Life Scale (SWLS), The Acceptance of Illness Scale (AIS), and The Life Orientation Test-Revised (LOT-R). The use of steroids and immunosuppressant drugs was also investigated. Symptoms of depression and anxiety were present in both groups, however the proportion of persons with mild or severe depression was higher among dialyzed patients. The AIS, LOT-R and SWLS scores were very similar in both the groups. The patients using steroids and/or immunosuppressant drugs were more prone to develop mild or severe depression according to the HAM-D scores. The results indicated a high prevalence of depression and anxiety among patients with CKD. Furthermore, the fraction of patients with depression is greater among hemodialyzed patients. This indicates the importance of monitoring the mental state of the patients as well as the necessity of providing timely psychological care for patients with CKD.