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Adejumo OA, Edeki IR, Sunday Oyedepo D, Falade J, Yisau OE, Ige OO, Adesida AO, Daniel Palencia H, Sabri Moussa A, Abdulmalik J, Noubiap JJ, Ekrikpo UE. Global prevalence of depression in chronic kidney disease: a systematic review and meta-analysis. J Nephrol 2024:10.1007/s40620-024-01998-5. [PMID: 38954184 DOI: 10.1007/s40620-024-01998-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Chronic kidney disease (CKD) is commonly associated with psychosocial problems, especially depression, contributing to poor overall outcomes. Depression has not been given adequate priority in the management of CKD patients despite its significant adverse impact on all major outcomes. This systematic review and meta-analysis determined the pooled prevalence of clinical depression in the global CKD population and sub-populations. METHODS PubMed, African Journals Online (AJOL), and EMBASE were systematically searched to identify published articles with relevant data. The pooled prevalence of clinical depression in the global CKD population was determined using random effects meta-analytic techniques. The study protocol was registered with PROSPERO (CRD42022382708). RESULTS Sixty-five articles were included in this review, comprising 80,932 individuals with CKD from 27 countries. The participants' mean age ranged from 11.0 to 76.3 years. Most (70.4%) of the studies had medium methodological quality. The overall pooled prevalence of depression was 26.5% (95% CI 23.1-30.1%). Studies using the Diagnostic Statistical Manual for Mental Diseases (DSM) and International Classification of Disease (ICD) returned a pooled prevalence of 25.5% and 39.6%, respectively, p = 0.03. There was a significant difference in the pooled prevalence across regions; p = 0.002.The prevalence of depression was higher among individuals on chronic hemodialysis compared to pre-dialysis patients (29.9% versus 18.5%; p = 0.01) and among those on hemodialysis compared to peritoneal dialysis (30.6% versus 20.4%; p = 0.04). There was no significant difference between adults and children (26.8% versus 15.9%, p = 0.21). There was an increasing temporal trend in depression prevalence, though this did not achieve statistical significance (p = 0.16). CONCLUSION Depression is common in patients with CKD. The findings of this study highlight the need for clinicians to make efforts to evaluate individuals with CKD for depression, especially those with advanced stages of the disease.
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Affiliation(s)
| | - Imuetinyan Rashida Edeki
- Department of Internal Medicine, University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | - Dapo Sunday Oyedepo
- Department of Internal Medicine, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Joshua Falade
- Department of Mental Health, University of Medical Sciences, Ondo, Ondo State, Nigeria
| | - Olawale Elijah Yisau
- Department of Internal Medicine, University of Medical Sciences, Ondo, Ondo State, Nigeria
| | - Olanrewaju Olumide Ige
- Department of Internal Medicine, University of Medical Sciences, Ondo, Ondo State, Nigeria
| | | | | | | | - Jibril Abdulmalik
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
- Directorate Office, Asido Foundation, Ibadan, Nigeria
| | - Jean Jacques Noubiap
- Division of Cardiology, Department of Medicine, University of California-San Francisco, San Francisco, CA, USA
| | - Udeme Ekpenyong Ekrikpo
- Research Team, DaVita HealthCare, Riyadh, Saudi Arabia.
- Department of Internal Medicine, University of Uyo, Uyo, Akwa Ibom State, Nigeria.
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Nagy E, Tharwat S, Elsayed AM, Shabaka SAEG, Nassar MK. Anxiety and depression in maintenance hemodialysis patients: prevalence and their effects on health-related quality of life. Int Urol Nephrol 2023; 55:2905-2914. [PMID: 37009953 PMCID: PMC10560136 DOI: 10.1007/s11255-023-03556-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/12/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE The aims of the study are to explore the prevalence and risk factors of anxiety and depression in hemodialysis (HD) patients and to study their relationship with quality of life (QOL). METHODS This cross-sectional study involved 298 HD patients. Sociodemographic, clinical, and laboratory data of the patients were obtained from their records. Anxiety and depression were assessed by utilizing Hospital Anxiety and Depression Scale (HADS). In addition, QOL of the patients were evaluated by fulfilling the Kidney Disease Quality of Life-36. RESULTS This study included 298 HD patients (male 59.1%) with a median age of 49 years. Abnormal and borderline cases of anxiety were recognized in 49.6%, 26.2% of the patients, respectively, while depression cases and borderline cases were identified in 55 and 28.2% of the patients, respectively. Percentages of females (41 and 48% vs 26.4%, respectively), and patients who were not working (92.3 and 93.9% vs 72.2%, respectively) increased significantly in borderline and abnormal anxiety groups. Patients who did not work, led an inactive lifestyle, and smoked had considerably greater percentages in the borderline and abnormal HADS-depression categories than normal patients. Abnormal cases of depression and anxiety had significantly longer duration of HD than other two groups. Abnormal and borderline cases of anxiety and depression had worse QOL components than the normal patients. CONCLUSION Anxiety and depression are prevalent among HD patients in Egypt, and several sociodemographic and clinical risk factors are associated. In addition, these mental disorders are associated with poor QOL.
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Affiliation(s)
- Eman Nagy
- Mansoura Nephrology and Dialysis Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Samar Tharwat
- Rheumatology and Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Shimaa Abd El-Galeel Shabaka
- Mansoura Nephrology and Dialysis Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohammed Kamal Nassar
- Mansoura Nephrology and Dialysis Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Al-Ebrahim SQ, Harrison J, Chen TF, Mohammed MA. Cross-cultural adaptation and psychometric properties of patient-reported outcome measures in Arabic speaking countries: A scoping review. Res Social Adm Pharm 2023; 19:989-1006. [PMID: 36941158 DOI: 10.1016/j.sapharm.2023.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/22/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are increasingly recognized as an indicator of healthcare quality and safety. Over the past decades, there has been a growing interest in using PROMs in Arabic-speaking populations. However, there is a paucity of data regarding the quality of their cross-cultural adaptation (CCA) and measurement properties. OBJECTIVES To identify PROMs that have been developed, validated or cross-culturally adapted to Arabic and evaluate methodological qualities of CCA and measurement properties. METHODS MEDLINE, EMBASE, CINAHL, PsycINFO, IPA, and ISI Web of Science were searched using search terms 'PROMs', 'Arabic countries', 'CCA', and 'psychometric properties'. Measurement properties were evaluated using COSMIN quality criteria and CCA quality was assessed using the Oliveria rating method. RESULTS This review included 260 studies with 317 PROMs, focusing on psychometric testing (83.8%), CCA (75.8%), utilizing PROMs as outcome measures (13.4%), and developing PROMs (2.3%). Out of the 201 cross-culturally adapted PROMs, forward translation was the most frequently reported component of CCA (n = 178), followed by back translation (n = 174). Out of the 235 PROMs that reported measurement properties, internal consistency was the most frequently reported measurement property (n = 214), followed by reliability (n = 160) and hypotheses testing (n = 143). Other measurement properties were less reported, including responsiveness (n = 36), criterion validity (n = 22), measurement error (n = 12), and cross-cultural validity (n = 10). The strongest measurement property was hypotheses testing (n = 143), followed by reliability (n = 132). CONCLUSION There are several caveats regarding the quality of CCA and measurement properties of PROMs included in this review. Only 1 out of 317 Arabic PROMs met CCA and psychometric optimal quality criteria. Therefore, there is a need to improve the methodological quality of CCA and measurement properties of PROMs. This review provides valuable information for researchers and clinicians when choosing PROMs for practice and research. There were only 5 treatment-specific PROMs, indicating the necessity for more research focusing on development and CCA of such measures.
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Affiliation(s)
- Sundos Q Al-Ebrahim
- Pharmacy Department, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
| | - Jeff Harrison
- Pharmacy Department, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
| | - Timothy F Chen
- Faculty of Pharmacy, The University of Sydney, Sydney, Australia.
| | - Mohammed A Mohammed
- Pharmacy Department, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
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Abdelwahab MMA, Sabri Y, Elkalla IHR, Nassar MK, Abdel-Gawad SM, Gomaa ZAE. Cognitive impairment in different hemodialysis techniques. MIDDLE EAST CURRENT PSYCHIATRY 2022. [DOI: 10.1186/s43045-022-00258-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Abstract
Background
Cognitive impairment is one of the most common, often untreated, comorbidities affecting patients with chronic kidney disease treated with hemodialysis. Increased mortality, poor compliance, depression, and poor quality of life were all linked to cognitive impairment in the hemodialysis population. The intradialytic exercise proved to be beneficial in improving patients’ quality of life, among other positive effects. Cooling dialysate has various positive effects, including improved patients’ mood and decreased hypotensive episodes during hemodialysis. The study aims to assess the effect of intradialytic exercise and cool hemodialysis on cognitive function in patients on hemodialysis.
Results
The study showed no significant effect of both interventions on the patient’s cognitive functions. However, cooling dialysate showed an improvement in the severity of depressive symptoms by Beck’s Depression Inventory II (p = 0.02). On the other hand, Mini-International Neuropsychiatric Interview showed an increase of patients diagnosed with depression in the intradialytic exercise group.
Conclusions
Both interventions had no significant effect on the mean scores of the Montreal Cognitive Assessment, which are lower in our sample than in the general population (23.9–25). Potential implications include the importance of managing psychiatric comorbidities in patients on hemodialysis. Cooling dialysate can be adopted to alleviate depressive symptoms in patients on hemodialysis.
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Abstract
PURPOSE OF REVIEW The aim of this study was to examine updated prevalence rates, risk factors and the prognosis, diagnosis and treatments for depression among dialysis patients. RECENT FINDINGS Depression influences prognosis, complications, quality of life (QOL), treatment and costs for dialysis patients worldwide. Reported prevalence of depression is 13.1-76.3%; it is higher for dialysis than transplant and higher post than predialysis. Reported depression rates with peritoneal dialysis (PD) compared with in-centre haemodialysis (HD) are inconsistent. Related medical factors are known, but suspected associated patient characteristics including gender and race remain unexplored. Associations between depression in dialysis and QOL, mortality, pathophysiological mechanisms of increased mortality, infection and pathways of inflammation-mediated and psychosocial factors require clarification. Several depression screening instruments are validated for dialysis patients - the Structured Clinical Interview for DSM disorders (SCID) remains the gold standard - but authors suggest the diagnostic standard should be higher than for the general population. Short-term studies indicate nonpharmacological therapy achieves clinical effects for depression in dialysis patients, but research on long-term effects is needed. SUMMARY Depression management through early screening and continuous care models emphasizing dynamic relationships between healthcare teams, patients and families should be encouraged. Large-scale studies of short-term and long-term benefits of pharmacological and nonpharmacological depression management are warranted.
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Affiliation(s)
- Na Tian
- Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia
| | - Na Chen
- Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia
| | - Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Carol and Richard Yu Peritoneal Dialysis Research Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
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Pretto CR, Winkelmann ER, Hildebrandt LM, Barbosa DA, Colet CDF, Stumm EMF. Quality of life of chronic kidney patients on hemodialysis and related factors. Rev Lat Am Enfermagem 2020; 28:e3327. [PMID: 32696925 PMCID: PMC7365615 DOI: 10.1590/1518-8345.3641.3327] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 04/08/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE to verify the association between the health-related quality of life of chronic renal patients on hemodialysis with sociodemographic, clinical, depression and medication adherence characteristics. METHOD a cross-sectional study with 183 chronic renal patients undergoing hemodialysis in the state of Rio Grande do Sul, Brazil. A sociodemographic and clinical questionnaire, Kidney Disease and Quality of Life Short-Form, Beck Depression Inventory and Morisky Medication Adherence Scale - eight items were used. Among the variables, comorbidities, complications of kidney disease and intercurrences during and after hemodialysis were evaluated. The analysis was performed with descriptive and analytical statistics. RESULTS 55.2% of the patients were 60 years old or older, 35.0% were hypertensive, with regular quality of life, average of 62.61. Scores below average in the dimensions of quality of life were mainly associated with repetitive infections and edema as complications of the disease, pain during hemodialysis and weakness afterwards. Low drug adherence resulted in a worse quality of life, impacting ten of the 20 dimensions evaluated and depression in all, except for patient satisfaction. CONCLUSION reduced quality of life in this population is associated with depressive symptoms, complications such as repetitive infections, pain and anemia, weakness after the dialysis session and low medication adherence. Actions aimed at changing these factors can promote well-being.
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Affiliation(s)
- Carolina Renz Pretto
- Departamento de Ciências da Vida, Universidade Regional do Noroeste do Estado do Rio Grande do Sul, Ijui, RS, Brazil
| | - Eliane Roseli Winkelmann
- Departamento de Ciências da Vida, Universidade Regional do Noroeste do Estado do Rio Grande do Sul, Ijui, RS, Brazil
| | | | - Dulce Aparecida Barbosa
- Departamento de Enfermagem Clínica e Cirúrgica, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Christiane de Fátima Colet
- Departamento de Ciências da Vida, Universidade Regional do Noroeste do Estado do Rio Grande do Sul, Ijui, RS, Brazil
| | - Eniva Miladi Fernandes Stumm
- Departamento de Ciências da Vida, Universidade Regional do Noroeste do Estado do Rio Grande do Sul, Ijui, RS, Brazil
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Abd Al-Maksoud AAH, Salama Al-Adl A, Fathi Asla A, Bahbah EI, Emad D, Mokhtar A, Attia MM. The Relation between Preserved Social Support, Resilience (Depression and Anxiety) and Psychiatric Disorders among a Sample of Egyptian Patients on Regular Hemodialysis. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2019. [DOI: 10.2174/2666082215666190917162630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Patients on hemodialysis are at a high risk of psychiatric disorders as they
face an emotional challenge in addition to physical impairment.
Objective:
This study aims to assess the prevalence of depression and anxiety among a sample of
patients with end-stage renal disease on regular dialysis, and the effect of resilience and social support
on them.
Methods:
This cross-sectional study was conducted on 45 patients who had been on hemodialysis
for the past three months. Anxiety and depression were assessed with a clinical interview. The severity
of depression, perceived social support, and resilience were assessed using the Beck Depression
Inventory (BDI), Multi-dimensional Scale of Perceived Social Support (MSPSS), and Resilience
Scale, respectively.
Result:
The mean age of enrolled patients was 49.2 ± 14.0 years, and the mean duration of hemodialysis
was 4.5 ± 3.8 years. The prevalence of depression was 24.4% and that of anxiety was 20%.
According to our analysis, 15 (33.3%) patients were diagnosed with minor depression, 6 (13.3%)
with mild depression, 14 (31.1%) with moderate depression, and 10 (22.2%) with severe depression.
Resilience correlated significantly with a psychiatric diagnosis (p=0.004). Perceived social support
was also found to be significantly correlated with a psychiatric diagnosis (p=0.012).
Conclusion:
Depression and anxiety are common mental disorders in patients with CKD and are
considered as the main determinants of quality of life and death rate. Increasing awareness, early
evaluation, and management of depression and anxiety may improve the functional, social, and
clinical outcomes of the patients with CKD.
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Affiliation(s)
| | - Ahmed Salama Al-Adl
- Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | | | | | - Doaa Emad
- Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Amal Mokhtar
- Faculty of Medicine, Al-Azhar University, Damietta, Egypt
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Jankowska‐Polańska B, Duczak A, Świątoniowska N, Karniej P, Seń M, Rosińczuk J. The influence of selected psychological variables on quality of life of chronically dialysed patients. Scand J Caring Sci 2019; 33:840-847. [DOI: 10.1111/scs.12680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 02/21/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Beata Jankowska‐Polańska
- Department of Clinical Nursing Public Health Department Wroclaw Medical University Wrocław Poland
| | - Agnieszka Duczak
- Department of Clinical Nursing Public Health Department Wroclaw Medical University Wrocław Poland
| | - Natalia Świątoniowska
- Department of Clinical Nursing Public Health Department Wroclaw Medical University Wrocław Poland
| | - Piotr Karniej
- Department of Health Promotion Public Health Department Wroclaw Medical University Wrocław Poland
| | - Mariola Seń
- Department of Health Promotion Public Health Department Wroclaw Medical University Wrocław Poland
| | - Joanna Rosińczuk
- Department of Clinical Nursing Public Health Department Wroclaw Medical University Wrocław Poland
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