Analysis of Depression Among Adult Indian Peritoneal Dialysis Patients

Abstract

Background

Depression has recently been recognized as a highly prevalent, treatable condition among dialysis patients, which adversely affects their outcome. The incidence of depression among dialysis patients is reported to be around 25-50% in various western studies. In the few studies that have looked at depression among the chronic peritoneal dialysis (PD) patients, depression has been variously linked with; adverse patient outcome, higher incidence of peritonitis and poor nutritional status. Only a few studies have looked at the socio-economic and medical factors associated with depression among these patients, especially from our sub-continent. The present study was therefore undertaken to look at; the prevalence of depression, factors associated with depression among Indian PD patients.

Methods

All consenting patients on PD for ≥6 months were administered Beck Depression Inventory (BDI) to screen for depression. Depression was classified on BDI scores as borderline to moderate (score ≥17) and severe (score >30). Patients demographic, medical and co-morbidity profile was also recorded.

Results

82 patients were administered BDI (mean PD duration, 47.6±21.1 months). 50 (61%) had depression (BDI scores 17-30), while 12.2% (n=10) had severe depression (BDI scores >30). On multivariate regression analysis we found that depressed patients had lower blood urea, serum alkaline phosphatase and serum albumin.  Residual renal function, duration of peritoneal dialysis and presence of diabetes and other co-morbid conditions did not correlate significantly with depression.

Conclusion

We document a high prevalence of depression among Indian PD patients.  Depressed patients had evidence of poor dietary protein intake and poorer nutrition as evidenced by lower serum urea and albumin. Further studies looking at effect of early detection and treatment of depression on PD outcome are warranted.