A Cross-Sectional Study on Prevalence of Depression in CKD Patients at a South Indian Tertiary Care Hospital

Abstract

Background Information: Chronic Kidney Disease (CKD) is one of the major causes of deaths reported in India. Chronic illnesses like CKD can lead to psychological distress. However, there are very few studies that determine the association of Depression with CKD and its predisposing factors. This study aims at finding out the prevalence of Depression in Chronic Kidney Disease patients and it’s correlation with age, gender and renal parameters of the disease like serum creatinine and BUN. Materials & Methods: We used a cross sectional design to recruit 123 CKD patients who were undergoing conservative and dialysis treatment at a tertiary care hospital in India. The structured questionnaire used in this study gathered information on respondent demographic and depression characteristics, and information obtained from the HAM D (Hamilton Depression Assessment scale) and PHQ 9 (Patient Health Questionnaire). Factors associated with depression were examined by chi square test. The socioeconomic status was evaluated using kuppuswamy SES scale. Statistical Consideration: All the raw data was collected, entered in excel sheet 2009 in window 10 version, the statistical analysis was done in SPSS 64 BIT version software by Chi square test statistical method for knowing the significant P Value. Results: The prevalence of depression was 62.6% (n=77) and 67.48%(n=83) with respect to HAM-D and PHQ 9 respectively. Age of the patients (P <0.05), Gender (P <0.01), and serum creatinine levels (P = 0.02, P =0.05 with HAM-D and PHQ 9 respectively), BUN (p=0.032, p=0.024 HAM-D and PHQ 9 respectively) showed a statistically significant association with depression. There was significant positive correlation between Age (r=0.231**; p=0.010; r=.130*, p=.052), BUN (r=.213*, P=018; r=.185*, p=.034), BUN: serum creatinine ratio (r= .261**, P=0.004; r=.120*, p=0.015) and depression severity. Most of the depressed patients were from upper lower economic class (32.5%,35.7% w.r.t HAM D and PHQ 9 respectively) Conclusion: The increased prevalence of depression was observed in CKD patients. We strongly recommend initiating screening of depression in CKD patients to improve the quality of life.