Prevalence of Depression in Patients with CKD 5 on Hemodialysis at A Tertiary Care Center in Nepal

Abstract

Introduction: Co-morbid depression impacts negatively on quality of life in Chronic Kidney Disease patients. It is unclear if self-reported depression rating scales can be used accurately for screening. The aim of this study was to estimate prevalence of depression in patients on hemodialysis using Patient Health Questionnaire-9 and compare Patient Health Questionnaire-9, Max Hamilton Rating scale and International Classification of Disease-10 for diagnosis of depression. Methods: It was descriptive cross-sectional study conducted from November 2017 till June 2018. Ethical approval was taken from Ethical Review Board, Nepal Health Research Council. Informed and written consent was taken. Patients undergoing hemodialysis at Nepal Medical College for > 3 months duration were included in study. Patients on hemodialysis were asked to fill validated Nepali translated version of Patient Health Questionnaire -9. Psychiatrist administered Max Hamilton Rating scale for diagnosis and categorization of depression and confirmed depression based on International Classification of Disease -10. Statistical Package for Social Sciences version 20 was used for statistical analysis. Results: Total of 100 patients completed study. Median age was 47.5 years. Prevalence of depression was 78 (78%) using Patient Health Questionnaire-9 and 65 (65%) using Max Hamilton Rating scale and 51 (51%) using International Classification of Disease -10. Mean depression in males using Patient Health Questionnaire -9 was 7±4.33 and in females was 11.04±5.90. The most common symptom was fatigue among 82 (82%). Conclusions: There is a high prevalence of depression in patients with Chronic Kidney Disease on hemodialysis compared to general population.

Keywords

• depression; hemodialysis; Nepal.