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Abstract
Introduction: Depression is a frequent yet underrecognized problem among patients with chronic kidney disease undergoing dialysis. The factors related to depression in dialysis patients appear to be varied.
Objetives: To identify clinical and demographic factors
related to depression in patients receiving dialysis.
Material and Method: A cross-sectional study was conducted with 50 patients from private hospital in Indonesia. Data collection includes demographic, health-related data, and depression. To identify the depression status, 20 items of Zung Self-Rating Depression Scale were utilized in this study. The data analysis includes univariate, bivariate and multivariate analysis. The dependent variable was analyzed using nonparametric analysis, and to determine the related factors of depression, regression analysis was used in this study.
Results: The average depression score was 31.1 (10.52),
indicating no clinical depression in most participants. No
demographic variables were associated with depression.
Prescribed anti-hypertension and angiotensin-converting
enzyme inhibitors were the predictors of depression in
patients undergoing dialysis.
Conclusions: Patientes with chronic kidned disease and
untreated hypertension experienced higher depression. The
use of antihypertensive medications, particularly angiotensinconverting enzyme inhibitors, was associated with lower depression scores in this sample of patients undergoing dialysis.
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Copyright (c) 2025 Septa Meriana Lumbantoruan
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References
- Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C. A single number for advocacy and communication—worldwide more than 850 million individuals have kidney diseases. Nephrology Dialysis Transplantation. 2019;34(11):1803–5. DOI: https://doi.org/10.1093/ndt/gfz174
- Jha V, Al-Ghamdi SMG, Li G, Wu MS, Stafylas P, Retat L, et al. Global Economic Burden Associated with Chronic Kidney Disease: A Pragmatic Review of Medical Costs for the Inside CKD Research Programme. Adv Ther. 2023 Oct 26;40(10):4405–20. DOI: https://doi.org/10.1007/s12325-023-02608-9
- Hustrini NM, Susalit E, Rotmans JI. Prevalence and risk factors for chronic kidney disease in Indonesia: An analysis of the National Basic Health Survey 2018. J Glob Health. 2022 Oct 14;12:04074. DOI: https://doi.org/10.7189/jogh.12.04074
- Ministry of Health Indonesia. 14 Maret Peringatan Hari Ginjal Sedunia (HGS) [Internet]. 2024; [consultado 2025 Feb 24]. Available from: https://setda.gunungkidulkab.go.id/2024/03/14/14-maret-peringatan-hari-ginjal-sedunia-hgs/#:~:text=Menurut%20Kemenkes%20penderita%20penyakit%20ginjal,tahunnya%20karena%20meningkatnya%20jumlah%20penderita
- Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National Kidney Foundation Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification. Ann Intern Med. 2003;139(2):137–47. DOI: https://doi.org/10.7326/0003-4819-139-2-200307150-00013
- Adejumo OA, Edeki IR, Sunday Oyedepo D, Falade J, Yisau OE, Ige OO, et al. Global prevalence of depression in chronic kidney disease: a systematic review and meta-analysis. J Nephrol. 2024;37(9):2455–72. DOI: https://doi.org/10.1007/s40620-024-01998-5
- Palapinyo S, Methaneethorn J, Leelakanok N. Association between polypharmacy and depression: a systematic review and meta-analysis. Journal of Pharmacy Practice and Research. 2021;51(4):280–99. DOI: https://doi.org/10.1002/jppr.1749
- Shirazian S. Depression in CKD: Understanding the Mechanisms of Disease. Kidney Int Rep. 2019;4(2):189–90. DOI: https://doi.org/10.1016/j.ekir.2018.11.013
- Qawaqzeh DTA, Masa’deh R, Hamaideh SH, Alkhawaldeh A, ALBashtawy M. Factors affecting the levels of anxiety and depression among patients with end-stage renal disease undergoing hemodialysis. Int Urol Nephrol. 2023;55(11):2887–96. DOI: https://doi.org/10.1007/s11255-023-03578-1
- Hawamdeh S, Almari A, Almutairi A, Dator W. Determinants and prevalence of depression in patients with chronic renal disease, and their caregivers. Int J Nephrol Renovasc Dis. 2017;Volume 10:183–9. DOI: https://doi.org/10.2147/IJNRD.S139652
- Wilson Van Voorhis CR, Morgan BL. Understanding Power and Rules of Thumb for Determining Sample Sizes. Tutor Quant Methods Psychol. 2007;3(2):43–50.
- ZUNG WWK. A Self-Rating Depression Scale. Arch Gen Psychiatry. 1965;12(1):63. DOI: https://doi.org/10.1001/archpsyc.1965.01720310065008
- Wilson Van Voorhis CR, Morgan BL. Understanding Power and Rules of Thumb for Determining Sample Sizes. Tutor Quant Methods Psychol. 2007;3(2):43–50. DOI: https://doi.org/10.20982/tqmp.03.2.p043
- Walters SJ, Campbell MJ. The use of bootstrap methods for estimating sample size and analysing health-related quality of life outcomes. Stat Med. 2005;24(7):1075–102. DOI: https://doi.org/10.1002/sim.1984
- Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl (2011). 2022;12(1):7–11. DOI: https://doi.org/10.1016/j.kisu.2021.11.003
- Kuma A, Kato A. Lifestyle-Related Risk Factors for the Incidence and Progression of Chronic Kidney Disease in the Healthy Young and Middle-Aged Population. Nutrients. 2022;14(18):3787. DOI: https://doi.org/10.3390/nu14183787
- Fatima S, Mahmood S. Combatting a silent killer - the importance of self-screening of blood pressure from an early age. EXCLI J. 2021;20:1326–7.
- Riskesdas K. Hasil utama riset kesehata dasar (RISKESDAS). J Phys A Math Theor. 2018;44(8):1–200.
- Mosleh H, Alenezi M, Al johani S, Alsani A, Fairaq G, Bedaiwi R. Prevalence and Factors of Anxiety and Depression in Chronic Kidney Disease Patients Undergoing Hemodialysis: A Cross-sectional Single-Center Study in Saudi Arabia. Cureus. 2020. DOI: https://doi.org/10.7759/cureus.6668
- D’Oro A, Patel DH, Wass S, Dolber T, Nasir K, Dobre M, et al. Depression and incident cardiovascular disease among patients with chronic kidney disease. International Journal of Cardiology Cardiovascular Risk and Prevention. 2023;18:200199. DOI: https://doi.org/10.1016/j.ijcrp.2023.200199
- Zhang Y, He D, Zhang W, Xing Y, Guo Y, Wang F, et al. ACE Inhibitor Benefit to Kidney and Cardiovascular Outcomes for Patients with Non-Dialysis Chronic Kidney Disease Stages 3-5: A Network Meta-Analysis of Randomised Clinical Trials. Drugs. 2020;80(8):797–811. DOI: https://doi.org/10.1007/s40265-020-01290-3
References
Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C. A single number for advocacy and communication—worldwide more than 850 million individuals have kidney diseases. Nephrology Dialysis Transplantation. 2019;34(11):1803–5. DOI: https://doi.org/10.1093/ndt/gfz174
Jha V, Al-Ghamdi SMG, Li G, Wu MS, Stafylas P, Retat L, et al. Global Economic Burden Associated with Chronic Kidney Disease: A Pragmatic Review of Medical Costs for the Inside CKD Research Programme. Adv Ther. 2023 Oct 26;40(10):4405–20. DOI: https://doi.org/10.1007/s12325-023-02608-9
Hustrini NM, Susalit E, Rotmans JI. Prevalence and risk factors for chronic kidney disease in Indonesia: An analysis of the National Basic Health Survey 2018. J Glob Health. 2022 Oct 14;12:04074. DOI: https://doi.org/10.7189/jogh.12.04074
Ministry of Health Indonesia. 14 Maret Peringatan Hari Ginjal Sedunia (HGS) [Internet]. 2024; [consultado 2025 Feb 24]. Available from: https://setda.gunungkidulkab.go.id/2024/03/14/14-maret-peringatan-hari-ginjal-sedunia-hgs/#:~:text=Menurut%20Kemenkes%20penderita%20penyakit%20ginjal,tahunnya%20karena%20meningkatnya%20jumlah%20penderita
Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National Kidney Foundation Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification. Ann Intern Med. 2003;139(2):137–47. DOI: https://doi.org/10.7326/0003-4819-139-2-200307150-00013
Adejumo OA, Edeki IR, Sunday Oyedepo D, Falade J, Yisau OE, Ige OO, et al. Global prevalence of depression in chronic kidney disease: a systematic review and meta-analysis. J Nephrol. 2024;37(9):2455–72. DOI: https://doi.org/10.1007/s40620-024-01998-5
Palapinyo S, Methaneethorn J, Leelakanok N. Association between polypharmacy and depression: a systematic review and meta-analysis. Journal of Pharmacy Practice and Research. 2021;51(4):280–99. DOI: https://doi.org/10.1002/jppr.1749
Shirazian S. Depression in CKD: Understanding the Mechanisms of Disease. Kidney Int Rep. 2019;4(2):189–90. DOI: https://doi.org/10.1016/j.ekir.2018.11.013
Qawaqzeh DTA, Masa’deh R, Hamaideh SH, Alkhawaldeh A, ALBashtawy M. Factors affecting the levels of anxiety and depression among patients with end-stage renal disease undergoing hemodialysis. Int Urol Nephrol. 2023;55(11):2887–96. DOI: https://doi.org/10.1007/s11255-023-03578-1
Hawamdeh S, Almari A, Almutairi A, Dator W. Determinants and prevalence of depression in patients with chronic renal disease, and their caregivers. Int J Nephrol Renovasc Dis. 2017;Volume 10:183–9. DOI: https://doi.org/10.2147/IJNRD.S139652
Wilson Van Voorhis CR, Morgan BL. Understanding Power and Rules of Thumb for Determining Sample Sizes. Tutor Quant Methods Psychol. 2007;3(2):43–50.
ZUNG WWK. A Self-Rating Depression Scale. Arch Gen Psychiatry. 1965;12(1):63. DOI: https://doi.org/10.1001/archpsyc.1965.01720310065008
Wilson Van Voorhis CR, Morgan BL. Understanding Power and Rules of Thumb for Determining Sample Sizes. Tutor Quant Methods Psychol. 2007;3(2):43–50. DOI: https://doi.org/10.20982/tqmp.03.2.p043
Walters SJ, Campbell MJ. The use of bootstrap methods for estimating sample size and analysing health-related quality of life outcomes. Stat Med. 2005;24(7):1075–102. DOI: https://doi.org/10.1002/sim.1984
Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl (2011). 2022;12(1):7–11. DOI: https://doi.org/10.1016/j.kisu.2021.11.003
Kuma A, Kato A. Lifestyle-Related Risk Factors for the Incidence and Progression of Chronic Kidney Disease in the Healthy Young and Middle-Aged Population. Nutrients. 2022;14(18):3787. DOI: https://doi.org/10.3390/nu14183787
Fatima S, Mahmood S. Combatting a silent killer - the importance of self-screening of blood pressure from an early age. EXCLI J. 2021;20:1326–7.
Riskesdas K. Hasil utama riset kesehata dasar (RISKESDAS). J Phys A Math Theor. 2018;44(8):1–200.
Mosleh H, Alenezi M, Al johani S, Alsani A, Fairaq G, Bedaiwi R. Prevalence and Factors of Anxiety and Depression in Chronic Kidney Disease Patients Undergoing Hemodialysis: A Cross-sectional Single-Center Study in Saudi Arabia. Cureus. 2020. DOI: https://doi.org/10.7759/cureus.6668
D’Oro A, Patel DH, Wass S, Dolber T, Nasir K, Dobre M, et al. Depression and incident cardiovascular disease among patients with chronic kidney disease. International Journal of Cardiology Cardiovascular Risk and Prevention. 2023;18:200199. DOI: https://doi.org/10.1016/j.ijcrp.2023.200199
Zhang Y, He D, Zhang W, Xing Y, Guo Y, Wang F, et al. ACE Inhibitor Benefit to Kidney and Cardiovascular Outcomes for Patients with Non-Dialysis Chronic Kidney Disease Stages 3-5: A Network Meta-Analysis of Randomised Clinical Trials. Drugs. 2020;80(8):797–811. DOI: https://doi.org/10.1007/s40265-020-01290-3