Published online Nov 19, 2023. doi: 10.5498/wjp.v13.i11.884
Peer-review started: September 5, 2023
First decision: September 14, 2023
Revised: September 22, 2023
Accepted: October 11, 2023
Article in press: October 11, 2023
Published online: November 19, 2023
According to the trend of global population aging, the proportion of elderly patients with chronic kidney disease (CKD) is expected to increase. However, there are more than 20 million people in China with decompensated kidney function, of which 19.25% are elderly people. Therefore, special attention should be paid to the education years, sleep quality, anxiety status, comorbidities with diabetes, cardiovascular disease (CVD), and anemia as independent risk factors for depression in elderly CKD patients. This study explores the clinical mana-gement of elderly CKD patients that should address these risk factors to prevent depression and improve their prognosis.
To investigate depression risk factors in older patients receiving peritoneal dialysis, aiding future prevention of depression in these patients.
This retrospective study included a primary study population of 170 patients with CKD who received peritoneal dialysis from January 2020 to December 2022. We assessed the patients’ mental status using the Beck Depression Inventory Score-II (BDI-II), Self-Rating Anxiety Scale (SAS), Anxiety Inventory Score, and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was employed to identify depression independent risk factors among these patients.
The non-depressed group had a significantly longer education period than the depressed group (P < 0.05). The depressed group exhibited significantly higher mental status scores than the non-depressed group (P < 0.001). Patients with diabetes mellitus (DM) or CVD had a higher probability of developing dep-ression. Patients with depression had significantly lower hemoglobin and albumin levels than patients without depression (P < 0.05). Spearman correlation analysis of BDI-II scale scores, measuring depression, indicated positive correlations with BDI-II and SAS scores as risk factors for depression in patients with CKD. In contrast, years of education, hemoglobin levels, and peritoneal Kt/V were negatively correlated, serving as protective factors against depression. An analysis of variance for influences with significant differences in the univariate analysis revealed that years of schooling, BDI-II, SAS, PSQI, DM, CVD, and hemoglobin levels independently influenced depression in older patients with CKD.
Education, BDI-II, SAS, PSQI, DM, and CVD are independent risk factors for depression in older patients with CKD; therefore, post-treatment psychological monitoring of high-risk patients is crucial to prevent depression.
Core Tip: We identified independent risk factors for depression in older patients with chronic kidney disease receiving peritoneal dialysis, including fewer years of education, higher Beck Depression Inventory Score-II and Self-Rating Anxiety Scale scores, poorer sleep quality, the presence of diabetes mellitus and cardiovascular disease, and lower hemoglobin and albumin levels. Conversely, more years of education, higher hemoglobin levels, and better peritoneal Kt/V ratio were associated with a lower risk of depression. These findings emphasize the importance of considering psychological well-being and addressing potential risk factors in the management of older patients on peritoneal dialysis, particularly in patients at high-risk of depression.