Depression in Patients with end Stage Renal Disease Attending Hemodialysis at Imam Al-Hussein Medical City, Karbala

Abstract

Background: Depression is a common psychological condition among patients with end-stage renal disease (ESRD) on hemodialysis because of chronic dependence on the hemodialysis machine for life, but it is unrecognized and underestimated. The experience of multiple losses in kidney function, family role, time, money, and work, in addition to the fear of death, all of which negatively affect the patient's mood and life. This study aims to determine the prevalence of depression among patients with ESRD on hemodialysis and factors associated with it.

Methods: A cross-sectional study was done in the hemodialysis unit in Imam AL Hussein Medical City in Karbala from 1st April 2024 to 30th June 2024 involving patients with ESRD on hemodialysis. Samples were collected consecutively from patients above 18 years old through direct interview using a semistructured questionnaire based on the Patient Health Questionnaire (PHQ-9) scale.

Results: Three hundred hemodialyzed patients were interviewed, among whom 59.3% were males and the remainder were females. The mean age of participants was 51.59 years. The prevalence of depression was 67%. A significant association was found between divorced, widowed, or not working patients and depression. Regarding PHQ-9, feeling of sadness was the most common symptom among participants at 82%.

Conclusions: Nearly two-thirds of patients with ESRD undergoing hemodialysis experienced depression, which was significantly associated with widowhood, divorce, and unemployment. Regular depression screening every 6–12 months is recommended, and future longitudinal, multicenter studies are warranted to clarify the predictors and outcomes of depression in this population.