Repeated measurements of depression and outcomes in patients receiving hemodialysis†

Objective: Depression appears to be common among the patients with end-stage renal disease (ESRD). Therefore, how to comprehensively analyze the changes in depression and its impact on patient outcomes is an important research direction. The objectives of this study were to assess changes in depression and whether depression can be used to predict outcomes in patients receiving hemodialysis.

Methods: In a longitudinal study, 317 patients receiving hemodialysis from two hospitals were investigated. Depression was assessed using the Hamilton Depression Scale (HAMDS) at baseline. Outcomes data (survival and mortality) were collected from baseline to the end of follow-up 2 years later. Mortality was assessed using Cox proportional hazards analysis.

Results: The HAMDS score and percentage of high scores increased at three time points. Moreover, the changes were statistically significant. Surviving patients had significantly lower HAMDS scores. Through multivariate Cox regression analysis, age and depression can be used to predict mortality (P < 0.05), and the relative risks (RRs) were 1.032 and 1.069, respectively.

Conclusions: Depression in patients receiving hemodialysis is worse. Moreover, baseline depression is an independent predictor of outcomes. Patients receiving hemodialysis should be focused on improving their psychological complications. A systematic and individual psychological health promotion plan must also be incorporated into the health education plan for patients receiving hemodialysis.