Depression among end stage renal disease patients on regular haemodialysis : comparing the haemoglobin, nutritional status, blood pressure control, fluid intake and adequacy of dialysis therapy between the depressed versus the nondepressed patients
Background: Depression is the most commonly encountered psychiatric problem in patients with end stage renal disease (ESRD) and has been shown to have a significant impact on the morbidity and mortality of these patients. The prevalence rate of depression in ESRD patients on haemodialysis as qu...
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| Main Author: | |
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| Format: | Thesis |
| Language: | English |
| Published: |
2005
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| Subjects: | |
| Online Access: | http://eprints.usm.my/47664/1/DR.%20AHLAM%20NAILA%20KORI-24%20pages.pdf |
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| Summary: | Background:
Depression is the most commonly encountered psychiatric problem in
patients with end stage renal disease (ESRD) and has been shown to have a
significant impact on the morbidity and mortality of these patients.
The prevalence rate of depression in ESRD patients on haemodialysis as
quoted by Kimmel et al (1998) was 50%. Unfortunately there was no local
data on the prevalence of depression in ESRD patients undergoing
haemodialysis; hence this study was conducted to address this issue. The
objective of the study was also to compare the differences in parameters
such as haemoglobin, nutritional status, blood pressure control and adequacy
of dialysis between the depressed versus the non depressed ESRD patients.
Methodology:
This was a cross sectional study conducted on all ESRD patients undergoing
haemodialysis in Hospital University Sains Malaysia (HUSM) and Renal
Care dialysis centre. The subjects were interviewed using a validated Malay
version of Hospital Anxiety and Depression Scale (HADS) questionnaire asa screening tool for depressive illness. The blood and dialysis parameters
such as haemoglobin, serum iron, renal function, serum albumin,
interdialytic weight gain and blood pressure were obtained and analyzed.
Amount of dialysis delivered was measured by urea kinetic modeling
(KtN).
Result:
The local prevalence of depressive illness among ESRD on regular
haemodialysis (using 11 as the cutoff point) obtained from this study was
56.8%.
On univariate analysis, this study had shown a significantly lower
haemoglobin level (1 0.4 vs 11.5; p < 0.009) and higher systolic blood
pressure (149.0 vs 138.6; p< 0.031) among the depressed group as compared
to the non depressed group of patients. Univariate analysis had also
significantly showed more proportion of female in the depressed group as
compared to the non depressed group (32.1% vs 24. 7%; p<0.027)
On further analysis with multivariate analysis, the haemoglobin and systolic
blood pressure control remain statistically significant with p<0.023 andp<0.008 respectively. Multivariate analysis had also significantly showed
more proportion of diabetics had depression as compared to non diabetics
with p<0.033.
Conclusion:
In conclusion, local prevalence of depressive illness amongst end stage renal
disease patients on haemodialysis was comparable to previous studies. We
also found that depressive state was significantly associated with lower
haemoglobin level and higher systolic blood pressure. Diabetes was also
shown to become an independent risk factor of developing depression. |
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