Anxiety and depression associated with social inequity indicators in patients with end-stage renal disease

Abstract

Objective: Determine the association between social inequality indicators and symptoms of anxiety and depression in patients with end-stage chronic kidney disease (ESRD). Methods: A cross-sectional analytical study was conducted in Tacna, Peru, involving patients with ESRD between July 1st and September 30th, 2023. Social inequality indicators included type of social insurance, educational level, and economic support. Anxiety and depression were assessed using the Hopkins Symptom Checklist-25 (HSCL-25). Results: A total of 207 ESRD patients were surveyed; 52.7 % were male, with a median age of 62 years (IQR 52–70). Symptoms of anxiety and depression were present in 43 % and 65.2 % of participants, respectively. In the adjusted model, anxiety symptoms were more prevalent among those with comprehensive health insurance coverage (aPR: 1.42; IC95 %: 1.0–2.0) and older adults (aPR: 1.72; 1.2–2.4) and less prevalent among males (aPR: 0.48; 0.3–0.7). Depression symptoms were less prevalent among those who were economically self-sufficient (aPR: 0.60; 0.4–0.8) and more prevalent in patients with anxiety symptoms (aPR: 1.77; 1.4–2.2). Conclusion: Anxiety and depression symptoms are common in patients with ESRD. We identified that social inequality indicators such as unemployment and type of health insurance were associated with higher anxiety and depression symptoms. Policies focusing on the social determinants of health are necessary, especially for vulnerable populations such as patients with ESRD.

Keywords

• Chronic kidney disease
• Hemodialysis
• Depression
• Anxiety (source: MeSH)