Depression and Chronic Kidney Disease: Risk Factors and Predictors in Nigerian Patients

Background: Depression is the most common psychological illness among patients with chronic kidney disease. There have been conflicting opinions and reports regarding the risk factors and predictors contributing to it. Systematic review studies report chronic kidney disease (CKD) stages 4 and 5 as having the highest prevalence rates of 22.8% and 39% respectively. This study intends to add to the growing knowledge on the predictors and other associated factors.

Methods: Patients attending the renal clinic in a teaching hospital, who met the inclusion criteria were recruited into the study. Socio-demographic data was obtained by interviewer technique and Patients Health Questionnaire (PHQ-9) was used as the instrument for depression related data aimed at identifying factors that may be contributing to depression and possibly predictive.

Results: The patients were predominantly males, of low socio-economic class and had little or no financial support. Hypertension was the leading comorbidity. The mean depression score (PHQ-9) was7.10+ 5.202, with 126 (63.5%) having depressive symptoms, out of which 55 (43.7%) turned out with major depression PHQ >10. Nine variables showed significant association (p<.05) with depression, but on bivariate logistic regression, unemployment-AOR=7.279, 95%CI: 2.04-25.92, p=.001, Financial support-AOR=5.075, 95%CI: 1.02-3.25, p=.001, CKD stages 3-5, AOR=56.533, 95% CI: 3.61-885.22, p=.003, and feeling that life depends on pills- AOR=3.582, 95%CI: 1.40-9.14, turned out as predictive factors.

Conclusion: Unemployment, no financial support, CKD stages 3-5 and patients feeling regarding the pills contribute significantly to clinical depression in CKD patients. Functional social support and routine screening of CKD patients for depression are strongly recommended.