Depression and anxiety among patients undergoing dialysis and kidney transplantation: a cross-sectional study

ABSTRACT

ABSTRACT BACKGROUND: Depression and anxiety are the most prevalent psychological disorders among end-stage renal disease patients and are associated with various conditions that result in poorer health outcomes, e.g. reduced quality of life and survival. We aimed to investigate the prevalences of depression and anxiety among patients undergoing renal replacement therapy. DESIGN AND SETTING: Cross-sectional study in Belo Horizonte, Brazil. METHODS: Patients' depression and anxiety levels were assessed using the Beck Inventory. The independent variables were the 36-Item Short-Form Health Survey (SF-36), Charlson Comorbidity Index and Global Subjective Assessment, along with sociodemographic and clinical characteristics. RESULTS: 205 patients were included. Depression and anxiety symptoms were detected in 41.7% and 32.3% of dialysis patients and 13.3% and 20.3% of transplantation patients, respectively. Lower SF-36 mental summary scores were associated with depression among transplantation patients (odds ratio, OR 0.923; 95% confidence interval, CI 0.85-0.99; P = 0.03) and dialysis patients (OR 0.882; 95% CI 0.83-0.93; P ≤ 0.001). Physical component summary was associated with depression among dialysis patients (OR 0.906; 95% CI 0.85-0.96; P = 0.001). Loss of vascular access (OR 3.672; 95% CI 1.05-12.78; P = 0.04), comorbidities (OR 1.578; 95% CI 1.09-2.27; P = 0.01) and poorer SF-36 mental (OR 0.928; 95% CI 0.88-0.97; P = 0.002) and physical (OR 0.943; 95% CI 0.89-0.99; P = 0.03) summary scores were associated with anxiety among ­dialysis patients. CONCLUSIONS: Depression and anxiety symptoms occurred more frequently among patients undergoing dialysis. Quality of life, comorbidities and loss of vascular access were associated factors.