Prevalence of Anxiety and Depression among Chronic Kidney Disease Patients in a Nigerian Tertiary Institution: A Comparison of Pre-dialysis and Hemodialysis Patients

Abstract

The global burden of Chronic Kidney Disease (CKD) is increasing with estimates suggesting that up to 10% of the world’s population is affected.  Anxiety and depression are the most commonly reported mental health conditions associated with CKD especially those on hemodialysis. Some of the factors associated with depression and anxiety among CKD patients include low income, low level of education and prolonged duration on dialysis.  We study the prevalence of anxiety and depression among chronic kidney disease patients and compare its occurrence between pre-dialysis and hemodialysis patients. This was a cross-sectional descriptive study of pre-dialysis and hemodialysis patients seen at the University of Uyo Teaching Hospital, Nigeria, from July 2024 to December 2024. Pre-dialysis subjects were recruited from the outpatient department, while hemodialysis subjects were recruited from the dialysis unit. Anxiety and depression were evaluated and recorded using a simple hospital anxiety and depression scale (HADS) screening tool A total of 148 participants were recruited for the study consisting of predominantly male 113 (76.4%), with females making up 35(23.6%). 75 (50.7%) were on hemodialysis while 73 (49.3%) were not on dialysis. 77.7% of subjects had depression, while78.4%) had anxiety.  Subjects on hemodialysis had 43.5% depression, (15.6% borderline and 27.9% clinical caseness) compared to 34.7% (22.5% borderline and 12.2% clinical caseness) pre-dialysis respondents (p-0.001). Hemodialysis participants had a significant anxiety disorder of 43.3% against 36% of pre-dialysis respondents. (P=0.02). Low income and hemodialysis were associated significantly with depression and anxiety, while prolonged duration of dialysis was mainly associated with depression. There is a high prevalence of depression and anxiety among CKD patients. This is further made worse by maintenance hemodialysis (MHD). Low income, hemodialysis and prolonged duration of MHD are associated with increased prevalence of depression.