Prevalence of Major Depressive Episode among Patients with Pre-Dialysis Chronic Kidney Disease

Abstract

Objective: To ascertain the prevalence of depression among pre-dialysis chronic kidney disease (CKD) patients. Methods: A cross-sectional study was carried out using the Structured Clinical Interview for DSM IV (SCID) to detect major depressive episode. Study was carried out in a nephrology outpatient clinic in Sri Lanka. Every fifth patient with CKD diagnosed according to the K/DQOI of the National Kidney Foundation of USA criteria stages 2–5 not undergoing dialysis was recruited. Primary outcome was major depressive episode diagnosed using the Structured Clinical Interview for DSM disorders (SCID). Results: Sample consisted of 140 patients. Eighty-nine (63.6%) were male. The mean age was 57.9 years ( SD = 10.4). Only 41 (29.3%) were in paid employment. Percentage of patients in CKD stages 2, 3, 4, and 5 were 2.9%, 19.6%, 51.4%, and 25%, respectively. Only three patients had diabetes. One hundred and five were on treatment for hypertension. Prevalence of a major depressive episode was 27.9%. Among males, prevalence was 27% (95% CI 17.6–36.3) and among females, 29.4% (95% CI 16.5–42.4). Age, gender, income, employment status, and education were not associated with depression. The only significant variable associated with depression was patient's understanding of prognosis. Conclusions: Prevalence of major depressive episode among pre-dialysis CKD patients was 27.9%. Rate of depression diagnosed using a structured clinical interview was lower than that reported when screening instruments were used. The only significant variable associated with depression was patient's understanding of prognosis. Future studies should aim to identify risk factors for depression among patients with kidney disease.