Association Between Anxiety and Depression With Dialysis Adequacy in Patients on Maintenance Hemodialysis

BACKGROUND Depression and anxiety are common among hemodialysis patients and affect their treatment outcomes. Dialysis adequacy also affects the hemodialysis patients' survival rates. OBJECTIVES This study aimed to evaluate the correlation between anxiety and depression with dialysis adequacy. PATIENTS AND METHODS In this cross-sectional study, 127 hemodialysis patients (73 males, 57.5%) with the mean age of 55.7 ± 17.5 were enrolled. Demographic and recent laboratory data were collected using self-administered questionnaires and by reviewing medical records. Dialysis adequacy measures including the Kt/V and urea reduction rate (URR) were calculated using standard formulas. The Hospital Anxiety and Depression Scale (HADS) was used to diagnose depression and anxiety. Independent sample t-test and Chi-square test were used to compare the values in different groups. Pearson correlations and linear regression were used to analyze the data using SPSS version 21. RESULTS The prevalence rates of depression and anxiety (HADS score ≥ 8) were 31.5% and 41.7%, respectively. The prevalence of both conditions was significantly higher in women than in men (P < 0.05). The mean values of Kt/V and URR were not different in patients with and without depression or anxiety. The anxiety scores were correlated with age (P = 0.007, r = -0.24) and parathyroid hormone (P = 0.04, r = -0.19). Younger age and lower parathyroid hormone were the only factors that predicted higher scores of anxiety in linear regression. The Kt/V or URR were not significantly correlated with depression and anxiety scores. CONCLUSIONS Depression and anxiety are common among hemodialysis patients. There are no statistically significant correlation between depression and anxiety and dialysis adequacy.