Association Between Anxiety and Depression With Dialysis Adequacy in Patients on Maintenance Hemodialysis

Abstract

Background: Depression and anxiety are common among hemodialysis patients and affect their treatment outcomes. Dialysis adequacy also affects the hemodialysis patients’ survival rates. Objectives: This study aimed to evaluate the correlation between anxiety and depression with dialysis adequacy. Patients and Methods: In this cross-sectional study, 127 hemodialysis patients (73 males, 57.5%) with the mean age of 55.7 ± 17.5 were enrolled. Demographic and recent laboratory data were collected using self-administered questionnaires and by reviewing medical records. Dialysis adequacy measures including the Kt/V and urea reduction rate (URR) were calculated using standard formulas. The Hospital Anxiety and Depression Scale (HADS) was used to diagnose depression and anxiety. Independent sample t-test and Chi-square test were used to compare the values in different groups. Pearson correlations and linear regression were used to analyze the data using SPSS version 21. Results: The prevalence rates of depression and anxiety (HADS score ≥ 8) were 31.5% and 41.7%, respectively. The prevalence of both conditions was significantly higher in women than in men (P < 0.05). The mean values of Kt/V and URR were not different in patients with and without depression or anxiety. The anxiety scores were correlated with age (P = 0.007, r = -0.24) and parathyroid hormone (P = 0.04, r = -0.19). Younger age and lower parathyroid hormone were the only factors that predicted higher scores of anxiety in linear regression. The Kt/V or URR were not significantly correlated with depression and anxiety scores. Conclusions: Depression and anxiety are common among hemodialysis patients. There are no statistically significant correlation between depression and anxiety and dialysis adequacy.