Abstract

Background: Chronic kidney disease (CKD) implies longstanding (more than 3 months), and usually progressive, impairment in renal function. Due to the life-long illness, majority of CKD patients may trigger physiologic, psychological, and social stressors at any point during the disease, thus, placing a barrier for them in maintaining the normal life-style and may also reduce their quality of life. Objectives: The study was designed; to find out the prevalence of depression among CKD patients on dialysis in central region of KSA and to evaluate their life style, social relationship & quality of life. Methods: It was an observational cross - sectional Hospital based study. The data was collected from 159 CKD patients of either sex from Haemodialysis units at King Abdulaziz Medical City, National Guard, Riyadh, King Saud Medical City, Riyadh and King Khalid General Hospital, Almajmaah. Demographic data was collected using a self-administered questionnaire, severity of depression was measured through "Beck Depression Inventory', and quality of life was measured through WHOQOL. All the data was entered and analyzed using SPSS 20.0. Results: The prevalence of depression among CKD patients was 57%. Majority of the patients had depression at the beginning of the condition after being diagnosed with CKD 112 (70.4%), majority of the patients 127 (79.9%) were leading normal social life despite of being diseased. Depression scale and depression at the beginning of the condition were significantly associated (p≤0.043), showing patients with mild mood disturbance (n≤48, 30.2%), those having borderline clinical depression were (n≤28, 17.6%), (n≤38, 23.9%) had moderate depression, whereas, (n≤23, 14.5%) had severe depression. Significant association was also observed between depression scale and the QOL scale (p<0.001), showing that those with acceptable quality of life had borderline depression (n≤22, 78.5%) and those with unacceptable quality of life, majority of them had severe depression (n≤16, 69.5%). Conclusion : A high proportion of CKD patients on dialysis experienced depression eventually resulting in an impaired quality of life.

Keywords: Chronic Kidney Disease · World Health Organization · Quality of Life · Depression

References

  1. 1.Parveen Kumar, Michael Clark. Kumar & Clark Clinical Medicine. Eighth edition. Elsevier Ltd. 2012; pp. 615
  2. 2.Levin A, Hemmelgarn B, Culleton B. Guidelines for the management of chronic kidney disease. CMAJ 2008; 179 (11): 1154–62.
  3. 3.Prevalence of Chronic Kidney Disease and Associated RiskFactors-UnitedStates,1999-2004CDC,accessed November 2013, http://www.cdc.gov/mmwr/ preview/mmwrhtml/mm5608a2.htm.
  4. 4.“CKD estimates - Neoerica 210209” public health England, accessed November 2013, http://www. apho.org.uk/resource/item.aspx?RID=63798.
  5. 5.Alsuwaida AO, Farag YM, Al Sayyari AA, Mousa D, Alhejaili F, Al-Harbi A et al. Epidemiology of chronic kidney disease in the Kingdom of Saudi Arabia (SEEK-Saudi investigators) - A pilot study. Saudi J Kidney Dis Transpl 2010;21: 1066-72.
  6. 6.Barlow DH. Abnormal psychology: An integrative approach (5th Ed.). Belmont, CA, USA: Thomson Wadsworth; 2005: 248–249.
  7. 7.PatelV,AbasM,BroadheadJ.Depressionindeveloping countries: Lessons from Zimbabwe. BMJ. 2001 [cited 2008-10-05];322(7284):482–84. doi:10.1136/ bmj.322.7284.482.
  8. 8.“The world health report 2001 - Mental Health: New Understanding, New Hope” World health Report, WHO, Accessed November 2013, http://www.who. int/whr/2001/en/index.html.
  9. 9.Andrade L, Caraveo-A. Epidemiology of major depressive episodes: Results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys .Int J Methods Psychiatry Res 2003;12:3–21.
  10. 10.KesslerRC,BerglundP,DemlerO.Theepidemiologyof major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003; 289:3095–105.
  11. 11.Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62:593–602.
  12. 12.Hedayati SS, Bosworth HB, Kuchibhatla M, Kimmel PL, Szczech LA: The predictive value of self-report scales compared with physician diagnosis of depression in hemodialysis patients. Kidney Int 2006; 69: 1662-1668.
  13. 13.Lopes AA, Bragg J, Young E, Goodkin D, Mapes D, Combe C et al. Depression as a predictor of mortality andhospitalizationamonghemodialysispatientsinthe United States and Europe. KidneyInternational 2002; 62: 199-207.
  14. 14.Molzahn AE. Psychosocial impact of renal disease. In:Parker J, ed. Contemporary Nephrology Nursing. Pitman,NJ:AmericanNephrologyNurses’Association; 1998: 269–84.
  15. 15.ZalaiD,SzeifertL,NovakM.Psychologicaldistressand depression in patients with chronic kidney disease. Semin Dial 2012;25:428-38.
  16. 16.KimmelPL,ThamerM,RichardCM,RayNF.Psychiatric illness in patients with end stage renal disease. Am J Med 1998; 105:214-221.
  17. 17.Arapaslan B, Soykan A, Soykan C, Kumbasar H. Cross- Depression and QoL in Patients with Chronic Kidney Disease, Mansour M Original Article 43  MAJMAAH JOURNAL OF HEALTH SCIENCE, Vol 2, Issue 2, 2014 Depression and QoL in Patients with Chronic Kidney Disease, Mansour M sectional assessment of psychiatric disorders in renal transplantation patients in Turkey: a preliminary study. Transplant Proc 2004;36:1419-1421
  18. 18.Cukor D, Coplan J, Brown C, Friedman S, Cromwell- Smith A, Peterson RA et al. Depression and anxiety in urban hemodialysis patients. Clin J Am Soc Nephrol 2007;2: 484-490
  19. 19.Drayer RA, Piraino B, Reynolds CF 3rd, Houck PR, Mazumdar S, Bernardini J et al. Characteristics of depression in hemodialysis patients: symptoms, quality of life and mortality risk. Gen Hosp Psychiatry 2006; 28:306-312.
  20. 20.Vázquez I, Valderrábano F, Fort J, Jofré R, López- Gómez JM, Moreno F et al. Psychosocial factors and health related quality of life in hemodialysis patients. Qual Life Res 2005;14:179-190.
  21. 21.Franke GH, Reimer J, Philipp T, Heemann U. Aspects ofqualityoflifethroughendstagerenaldisease.Qual Life Res 2003;12:103-115.
  22. 22.Cruz MC, Andrade C, Urrutia M, Draibe S, Nogueira- Martins LA, Sesso Rde C. Quality of life in patients with chronic kidney disease. Clinics (Sao Paulo) 2011 June; 66: 991–995. Original Article
Majmaah Journal of Health Sciences · eISSN 1658-8223 · Majmaah University · open access