Prevalence of depression and risk factors in maintenance hemodialysis patients

doi:10.3877/cma.j.issn.2095-3216.2018.05.004

Abstract

Abstract:

Objective

To investigate the prevalence of depression and risk factors in maintenance hemodialysis (MHD) patients.

Methods

One hundred and ninety-three MHD patients were enrolled in this study. The patient health questionnaire-9 (PHQ-9) was used to evaluate patients. According to the scores of PHQ-9, the patients were divided into non-depression group (n=101) and depression group (n=92). Patients with PHQ-9 score<4 points belonged to the non-depression group, while patients with PHQ-9 score≥5 points belonged to the depression group. The differences between the two groups were compared in gender, age, body mass index (BMI), marital status, work, smoking, drinking, medical insurance, month-age of hemodialysis, interdialytic weight gain (IWG), Charlson comorbidity index , spKt/V, serum albumin, and hemoglobin. Logistic regression method was used to analyze the risk factors of depression in MHD patients.

Results

Among the 193 patients with MHD, the incidence of depression was 47.6% (92 cases). Age (OR=1.03, P=0.038), dialysis age (OR=1.02, P=0.032), IWG(%) (OR=1.71, P=0.025), Charlson comorbidity index (OR=1.78, P=0.008), type of medical insurance (OR=3.27, P=0.021), spKt/V (OR=0.01, P<0.001), hemoglobin (OR=0.82, P<0.001), and serum albumin (OR=0.87, P=0.032) were independent risk factors for depression in patients with MHD. The work status was related to the prevalence of depression (P=0.033), and the incidence of depression among unemployed patients (OR=4.41, P=0.012) and retired patients (OR=3.19, P=0.049) was higher than that of in-service patients.

Conclusion

In MHD patients, the incidence of depression was high. The increase in age, complications, dialysis age, IWG, and the proportion of medical expenses were risk factors for depression, while the work status, increase of dialysis adequacy, anemia correction, and elevation of serum albumin were protective factors for depression.

Key words: Depression, Maintenance hemodialysis, Patient health questionnaire, End-stage renal disease

Qiang Fang, Yan Chen, Dongsheng Jiang. Prevalence of depression and risk factors in maintenance hemodialysis patients[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2018, 07(05): 207-210.

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References 17

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?			非抑郁组(n＝101)	抑郁组(n＝92)	t/z/χ²值	P值
人口学信息			?	?	?	?
?	性别		?	?	?	?
?	?	男	65	44	?	?
?	?	女	36	48	5.35	0.02
?	年龄(岁)		50.33±19.14	55.59±15.77	－2.07	0.04
?	BMI(kg/m²)		21.89±4.85	23.86±4.69	－2.86	0.01
社会学信息			?	?	?	?
婚姻情况			?	?	?	?
?	已婚		65	70	?	?
?	单身		36	22	3.15	0.07
工作情况			?	?	?	?
?	在职		46	23	?	?
?	无业		26	35	?	?
?	退休		29	34	8.99	0.01
吸烟			46	43	0.28	0.88
饮酒			35	46	4.66	0.03
医疗保险情况			?	?	?	?
?	职工医保		79	60	?	?
?	农村合作医疗		22	32	4.04	0.04
疾病相关信息			?	?	?	?
?	透析月龄		52.36±23.38	61.81±21.52	－2.92	0.004
?	IWG(%)		3.87±1.03	4.21±0.96	－2.39	0.02
?	CCI		5(4，5)	5(4，6)	3.40	0.02
?	spKt/v		1.92±0.27	1.66±0.19	7.76	<0.001
?	血红蛋白(g/L)		111.69±6.91	103.03±6.73	8.79	<0.001
?	血清白蛋白(g/L)		38.20±3.67	35.95±4.02	4.05	<0.001

?			非抑郁组(n＝101)	抑郁组(n＝92)	t/z/χ²值	P值
人口学信息			?	?	?	?
?	性别		?	?	?	?
?	?	男	65	44	?	?
?	?	女	36	48	5.35	0.02
?	年龄(岁)		50.33±19.14	55.59±15.77	－2.07	0.04
?	BMI(kg/m²)		21.89±4.85	23.86±4.69	－2.86	0.01
社会学信息			?	?	?	?
婚姻情况			?	?	?	?
?	已婚		65	70	?	?
?	单身		36	22	3.15	0.07
工作情况			?	?	?	?
?	在职		46	23	?	?
?	无业		26	35	?	?
?	退休		29	34	8.99	0.01
吸烟			46	43	0.28	0.88
饮酒			35	46	4.66	0.03
医疗保险情况			?	?	?	?
?	职工医保		79	60	?	?
?	农村合作医疗		22	32	4.04	0.04
疾病相关信息			?	?	?	?
?	透析月龄		52.36±23.38	61.81±21.52	－2.92	0.004
?	IWG(%)		3.87±1.03	4.21±0.96	－2.39	0.02
?	CCI		5(4，5)	5(4，6)	3.40	0.02
?	spKt/v		1.92±0.27	1.66±0.19	7.76	<0.001
?	血红蛋白(g/L)		111.69±6.91	103.03±6.73	8.79	<0.001
?	血清白蛋白(g/L)		38.20±3.67	35.95±4.02	4.05	<0.001

指标		回归系数	OR值	95%CI		P值
指标		回归系数	OR值	下限	上限	P值
年龄(岁)		0.03	1.03	1.00	1.06	0.038
BMI(kg/m²)		－0.01	0.99	0.90	1.09	0.88
性别(男)		0.84	2.31	0.91	5.90	0.079
工作情况		?	?	?	?	0.033
?	无业与在职比较(0/1)	1.49	4.41	1.38	14.08	0.012
?	退休与在职比较(0/1)	1.16	3.19	1.00	10.18	0.049
饮酒(0/1)		－0.86	0.42	0.16	1.11	0.08
医疗保险(0/1)		1.19	3.27	1.19	8.99	0.021
透析(月)		0.02	1.02	1.00	1.05	0.032
IWG(%)		0.54	1.71	1.07	2.75	0.025
CCI		0.57	1.78	1.16	2.72	0.008
spKt/v		－4.53	0.01	0.001	0.13	<0.001
血红蛋白(g/L)		－0.2	0.82	0.76	0.88	<0.001
血清白蛋白(g/L)		－0.14	0.87	0.76	0.99	0.032

指标		回归系数	OR值	95%CI		P值
指标		回归系数	OR值	下限	上限	P值
年龄(岁)		0.03	1.03	1.00	1.06	0.038
BMI(kg/m²)		－0.01	0.99	0.90	1.09	0.88
性别(男)		0.84	2.31	0.91	5.90	0.079
工作情况		?	?	?	?	0.033
?	无业与在职比较(0/1)	1.49	4.41	1.38	14.08	0.012
?	退休与在职比较(0/1)	1.16	3.19	1.00	10.18	0.049
饮酒(0/1)		－0.86	0.42	0.16	1.11	0.08
医疗保险(0/1)		1.19	3.27	1.19	8.99	0.021
透析(月)		0.02	1.02	1.00	1.05	0.032
IWG(%)		0.54	1.71	1.07	2.75	0.025
CCI		0.57	1.78	1.16	2.72	0.008
spKt/v		－4.53	0.01	0.001	0.13	<0.001
血红蛋白(g/L)		－0.2	0.82	0.76	0.88	<0.001
血清白蛋白(g/L)		－0.14	0.87	0.76	0.99	0.032

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