Prevalence and Factors Associated with Depression and Anxiety in Patients with Chronic Kidney Disease

Depression and anxiety are common in chronic kidney disease (CKD) and can increase morbidity and mortality. Therefore, the objective was to analyze their prevalence and the associated demographic, clinical, and laboratory factors in CKD patients undergoing dialysis.

Correlational design research with prospective cohort. Sample of 107 patients, 67 on hemodialysis and 40 on peritoneal dialysis (PD). The Hospital Anxiety and Depression Scale questionnaire was used after obtaining free and informed consent. The Spearman correlation coefficient, Chi ² and multivariate ordinal logistic regression analysis were used.

Females predominated in both dialysis groups. Hemodialysis patients were mostly single, unemployed, and had primary or secondary education, whereas peritoneal dialysis patients were predominantly married, employed, and had higher education. Hypertension and diabetes mellitus were the leading causes of CKD. The overall prevalence of anxiety and depressive symptoms was 56.0% and 69.2%, respectively. Depression was more frequent among hemodialysis patients, whereas moderate-to-severe anxiety symptoms predominated in the peritoneal dialysis group. Depression was significantly associated with employment status, serum urea, hemoglobin, and phosphorus levels, while anxiety was inversely associated with hemoglobin levels. Multivariable ordinal logistic regression identified older age and lower serum calcium levels as independent correlates of greater anxiety severity. Older age, single marital status, sleep disorders, cancer, hepatitis C, and lower serum calcium levels were independently associated with greater depressive symptom severity.

Early identification of anxiety and depressive symptoms in patients with CKD undergoing dialysis is essential to facilitate timely and appropriate management.