Level Of Depression And Anxiety In Maintenance Dialysis Patients Undergoing Treatment In Public Sector Hospitals Of Peshawar.
Abstract
INTRODUCTION: Dialysis is a life-support treatment that uses a special machine to filter harmful wastes, salt, and excess fluid from your blood. This restores the blood to a normal, healthy balance. Dialysis replaces many of the kidney’s important functions. Hemodialysis is the most common form of renal replacement therapy in ESRD and is also used in AKI. Depression and anxiety are the most common co-morbid illnesses in people with end stage renal disease.
OBJECTIVE: To find out the level of anxiety and depression in maintenance dialysis patients in major public hospitals of Peshawar. To assess frequency of anxiety and depression among male and female. To find out association of anxiety and depression with age, duration of illness and comorbidities such as diabetes, hypertension and anemia.
METHODOLOGY: A cross-sectional study was conducted in major public sector hospitals of Peshawar including Lady Reading Hospital, Khyber Teaching Hospital and Institute of Kidney Diseases. The patients were interviewed using Agha Khan University Anxiety and Depression Scale (AKUADS). Patients undergoing dialysis in the nephrology units of aforementioned hospitals were selected. Patients were included if they were diagnosed with Acute Kidney Injury (AKI) or Chronic Kidney Disease (CKD). Exclusion criteria included patients in critical conditions or having language / hearing problems, cognitive impairment or incomplete records. Non-probability Consecutive Sampling technique was used. Regarding ethical consideration, prior permission was taken from the concerned head of department in each hospital and confidentiality of subjects was assured. The data was analyzed using SPSS Version 23 and Microsoft Excel 2015. The study duration was almost 3 months.
RESULTS: A total of 159 patients were interviewed among which only 106 (66%) patients gave consent for participation. Mean AKUADS score was 30.47 ± 9.38. Among the patients who gave their consent for participation 85% were found to be mildly anxious and depressed while 21% were moderately anxious and depressed. In our study we came-across no patient of anxiety and depression of severe nature. More males (61%) suffered from mild depression while more females (60%) suffered from moderate depression. Patients with CKD were more depressed (mean AKUADS score was 31.01 ± 12.24) as compared to patients with AKI. Patients suffering from comorbidities were relatively more depressed.
CONCLUSION: Patients with CKD or AKI suffer from anxiety and depression which may have profound effects on their quality of life and response to treatment.
KEY WORDS: Dialysis, anxiety, depression, chronic kidney disease, acute kidney injury, end stage renal disease
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