Prevalence of Depression in Hemodialysis Patients: A Meta-Analysis

Depression is the third most disabling disease worldwide and is prevalent in patients undergoing hemodialysis. Given the greatly varied prevalence of depression in different regions, this meta-analysis was conducted to elucidate the status of depression in hemodialysis patients.

PubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant literature on depression in hemodialysis patients from inception to July 2023. Subgroup analyses and meta-regression were subsequently performed to determine the source of heterogeneity.

A total of 137 cross-sectional studies were included, involving 21,608 hemodialysis patients. The random-effects analyses demonstrated that the prevalence of depression was 45.8% in hemodialysis patients (95% confidence interval [CI]: 42.0%-49.6%). Subgroup analysis of national income levels implied that high-income countries had the lowest prevalence of depression at 38.9% (95% CI: 34.1%-43.7%). Studies with a higher proportion of female hemodialysis patients reported a relatively higher prevalence of depression. Subgroup analysis by age revealed that patients under 40 years old had a depression prevalence of 50.8% (95% CI: 25.6%-76.0%), which was higher than that of other age groups. Different self-rating depression scales yielded different prevalence of depression in hemodialysis patients.

Depressive symptoms are common in hemodialysis patients, so screening and identifying those at risk for depression and developing effective intervention strategies are of great value.