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.