Ahlawat Rajiv, Tiwari Pramil, D'Cruz Sanjay
Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Mohali, Punjab, India.
Department of General Medicine, Government Medical College and Hospital, Chandigarh, India.
Saudi J Kidney Dis Transpl. 2018 Sep-Oct;29(5):1165-1173. doi: 10.4103/1319-2442.243972.
Chronic kidney disease (CKD) patients are at high risk of depressive disorders because of considerable psychological stress due to physical and social changes brought on by disease. The aim of this study is to assess the prevalence of depression in patients with CKD and the factors affecting it at a public tertiary care hospital. This cross-sectional study was carried out at the renal clinic of a tertiary care hospital. Data on 612 patients diagnosed with CKD from September 2014 to April 2016 was obtained. Nine-item Patient Health Questionnaire from PRIME-MD was used to assess the depression. Of all the patients, 55.9% had no depression. Mild depression was found to affect 28.4% of the patients followed by moderate depression, moderately severe, and severe depression (11.8%, 3.8%, and 0.8%, respectively). According to multiple logistic regression, the occurrence of depression was significantly higher with age below 60 years [odds ratio (OR) 1.6, 0.8-2.7; P<0.05], male gender (OR 1.3, 0.9-3.1; P<0.05), no treatment funding (OR 2.6, 1.2-4.5; P<0.05), education less than grade 12 (OR1.3, 1.3-3.2; P<0.05), monthly income ≤INR 20,000 (OR 1.6, 1.1-3.6; P<0.05), CKD stage V (OR 1.3, 1.02.9; P <0.05), Patients on hemodialysis (hD) (OR 2.6, 1.2-4.5; P<0.05), comorbidities ≥3 (OR 1.7, 1.1-2.9; P<0.05), overweight (OR 2.5, 1.3-2.9; P<0.05), and duration of CKD >2 (OR 2.2, 1.3-4.3; P<0.05). About 44% of the patients were found to have depression. Patients' age, gender, body mass index, treatment funding, education status, income, CKD duration and stage, HD status, and comorbidities were found to be significant factors affecting depression.
慢性肾脏病(CKD)患者因疾病带来的身体和社会变化而承受相当大的心理压力,故而患抑郁症的风险很高。本研究旨在评估一家公立三级医疗机构中CKD患者的抑郁症患病率及其影响因素。这项横断面研究在一家三级医疗机构的肾脏门诊开展。收集了2014年9月至2016年4月期间612例确诊为CKD患者的数据。采用PRIME-MD的九项患者健康问卷来评估抑郁症。在所有患者中,55.9%无抑郁。轻度抑郁影响了28.4%的患者,其次是中度抑郁、中重度抑郁和重度抑郁(分别为11.8%、3.8%和0.8%)。根据多因素逻辑回归分析,年龄低于60岁(比值比[OR]1.6,0.8 - 2.7;P<0.05)、男性(OR 1.3,0.9 - 3.1;P<0.05)、无治疗资金(OR 2.6,1.2 - 4.5;P<0.05)、教育程度低于12年级(OR1.3,1.3 - 3.2;P<0.05)、月收入≤20,000印度卢比(OR 1.6,1.1 - 3.6;P<0.05)、CKD 5期(OR 1.3,1.0 - 2.9;P <0.05)、接受血液透析(HD)的患者(OR 2.6,1.2 - 4.5;P<0.05)、合并症≥3种(OR 1.7,1.1 - 2.9;P<0.05)、超重(OR 2.5,1.3 - 2.9;P<0.05)以及CKD病程>2年(OR 2.2,1.3 - 4.3;P<0.05)时,抑郁症的发生率显著更高。约44%的患者被发现患有抑郁症。患者的年龄、性别、体重指数、治疗资金、教育状况、收入、CKD病程和分期、HD状态以及合并症被发现是影响抑郁症的重要因素。