Cho Ahyeon, Tran Tammy, Telfer Laura, Matarneh Ahmad, Sardar Sundus, Ghahramani Nasrollah
Pennsylvania State University College of Medicine, Hershey, PA, USA.
Division of Nephrology, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.
SAGE Open Med. 2025 Aug 23;13:20503121251353028. doi: 10.1177/20503121251353028. eCollection 2025.
Depression affects 38%-80% of end-stage renal disease patients on dialysis, causing increased hospitalizations, treatment nonadherence, and mortality rates. While various interventions have been researched, a comprehensive assessment remains necessary to address the psychological burden effectively.
To assess previous research from 2017 to 2023 on the efficacy of pharmacological and non-pharmacological interventions for depressive symptoms in this group.
A systematic review was performed across PubMed, ScienceDirect, Clinical Key, and Web of Science. Citations for inclusion and abstract extraction were assessed and confirmed by two independent researchers. Inclusion criteria consisted of clinical trials, randomized controlled trials, and prospective studies written in English. We excluded studies that were review articles, case reports, or editorials, or did not examine antidepressants, exercise, or other mental health interventions in dialysis patients. To assess risk of bias, the Risk of Bias 2 and the Risk of Bias in Non-randomized Studies of Interventions tools were utilized. Depressive symptoms were measured using different scales.
Among 911 screened citations, 30 articles were included, involving 1815 participants across 17 countries. Publications on antidepressant medication ( = 4), exercise ( = 9), music therapy ( = 4), and psychotherapy ( = 13) were included.
While interventions like antidepressants, intradialytic exercise, music therapy, and psychotherapy show potential for managing depression in dialysis patients, small sample sizes, lack of control groups, and short treatment durations continue to limit current studies. Future research should focus on multicenter trials with larger, more diversified populations and stronger study designs.
抑郁症影响着38%-80%的接受透析治疗的终末期肾病患者，导致住院率增加、治疗依从性降低以及死亡率上升。虽然已经对各种干预措施进行了研究，但仍需要进行全面评估，以有效解决心理负担问题。
评估2017年至2023年期间关于该群体抑郁症状的药物和非药物干预疗效的既往研究。
在PubMed、ScienceDirect、Clinical Key和Web of Science上进行了系统综述。纳入文献的引用和摘要提取由两名独立研究人员进行评估和确认。纳入标准包括用英文撰写的临床试验、随机对照试验和前瞻性研究。我们排除了综述文章、病例报告或社论，以及未研究透析患者抗抑郁药、运动或其他心理健康干预措施的研究。为了评估偏倚风险，使用了偏倚风险2工具和非随机干预研究中的偏倚风险工具。使用不同量表测量抑郁症状。
在911篇筛选出的文献中，纳入了30篇文章，涉及17个国家的1815名参与者。纳入了关于抗抑郁药物（n = 4）、运动（n = 9）、音乐疗法（n = 4）和心理治疗（n = 13）的出版物。
虽然抗抑郁药、透析期间运动、音乐疗法和心理治疗等干预措施在管理透析患者抑郁症方面显示出潜力，但样本量小、缺乏对照组以及治疗持续时间短仍然限制了当前的研究。未来的研究应侧重于针对更大、更多样化人群且研究设计更强的多中心试验。
