Raghavan Ajay, Billa Varun, Billa Viswanath
Department of Psychiatry, Karnataka Institute of Medical Sciences, KIMS Campus, Vidyanagar, Hubli, India.
Department of Political Science, University of Toronto, Toronto, Canada.
Indian J Nephrol. 2025 Jul-Aug;35(4):530-535. doi: 10.25259/IJN_199_2024. Epub 2024 Sep 26.
Chronic kidney disease poses significant morbidity on patients and subjects them to stressors in financial, occupational, and social aspects, making them vulnerable to mental health problems. We estimated the prevalence of depression in CKD patients undergoing maintenance hemodialysis (MHD) and evaluated the factors affecting it.
This cross-sectional survey included 282 patients from four Apex Kidney Care centers, Mumbai. Their mental health was assessed using PHQ-9 survey, a validated questionnaire for identifying depression. Categorical variables were compared using the Chi square test and continuous variables with the Mann Whitney U test. Logistic regression was used for multivariate analysis and odds ratios were calculated.
Females constituted 36.52% of the study population. There was an equal distribution of patients from charitable centers (142 patients) and private centers (140 patients). The current analysis focused on those patients (n = 60) with significant depression i.e. a PHQ-9 score of 10 or greater, and these were compared to the rest of patients (n = 222). In logistic regression, female gender (p = 0.002), catheter as access (p = 0.025), stress of food restriction (p < 0.0001) showed statistically significant positive association, whereas being employed (p = 0.022) showed statistically significant negative association with depression. The distribution of patients with significant depression in both public (21.10%) and private (21.40%) centers was equal.
The prevalence of depression in MHD patients is substantial. Employment status, catheter access, and food restrictions are the modifiable factors influencing mental health. A focused approach on maximizing arterio-venous fistula creation, diet counseling, employment friendly shift adjustments, and mental health counseling can help mitigate this challenge.
慢性肾脏病给患者带来了严重的发病风险，并使他们在经济、职业和社会方面面临压力源，从而使他们易患心理健康问题。我们估计了接受维持性血液透析（MHD）的慢性肾脏病患者中抑郁症的患病率，并评估了影响该患病率的因素。
这项横断面调查纳入了来自孟买四个顶点肾脏护理中心的282名患者。使用PHQ-9调查问卷评估他们的心理健康状况，PHQ-9是一份用于识别抑郁症的经过验证的问卷。分类变量采用卡方检验进行比较，连续变量采用曼-惠特尼U检验进行比较。采用逻辑回归进行多变量分析并计算比值比。
女性占研究人群的36.52%。慈善中心（142例患者）和私立中心（140例患者）的患者分布均衡。当前分析聚焦于那些患有严重抑郁症的患者（n = 60），即PHQ-9评分达到10分或更高，将这些患者与其余患者（n = 222）进行比较。在逻辑回归中，女性性别（p = 0.002）、以导管作为血管通路（p = 0.025）、食物限制带来的压力（p < 0.0001）显示出具有统计学意义的正相关，而就业（p = 0.022）与抑郁症显示出具有统计学意义的负相关。公立中心（21.10%）和私立中心（21.40%）中患有严重抑郁症的患者分布相当。
维持性血液透析患者中抑郁症的患病率很高。就业状况、导管血管通路和食物限制是影响心理健康的可改变因素。集中精力最大化动静脉内瘘的建立、饮食咨询、调整有利于就业的班次以及心理健康咨询有助于应对这一挑战。
