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: Kori, Ahlam Naila
Format: Thesis
Language:English
Published: 2005
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Online Access:http://eprints.usm.my/47664/1/DR.%20AHLAM%20NAILA%20KORI-24%20pages.pdf
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spelling my-usm-ep.476642022-05-23T07:12:50Z 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 2005 Kori, Ahlam Naila RC31-1245 Internal medicine 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. 2005 Thesis http://eprints.usm.my/47664/ http://eprints.usm.my/47664/1/DR.%20AHLAM%20NAILA%20KORI-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution Universiti Sains Malaysia
collection USM Institutional Repository
language English
topic RC31-1245 Internal medicine
spellingShingle RC31-1245 Internal medicine
Kori, Ahlam Naila
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
description 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.
format Thesis
qualification_level Master's degree
author Kori, Ahlam Naila
author_facet Kori, Ahlam Naila
author_sort Kori, Ahlam Naila
title 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
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
granting_institution Universiti Sains Malaysia
granting_department Pusat Pengajian Sains Perubatan
publishDate 2005
url http://eprints.usm.my/47664/1/DR.%20AHLAM%20NAILA%20KORI-24%20pages.pdf
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