ISSN: 2251-8363    eISSN: 2251-8819  
J Nephropathol. 2018;7(4):224-232.
doi:10.15171/jnp.2018.47

Review Article

Prevalence of depression among Iranian patients under hemodialysis: a systematic review and meta-analysis

Alireza Abdi, Sahar Dalvand, Amir Vahedian-azimi, Reza Ghanei Gheshlagh * , Amanj Kurdi 5

1 Nursing and Midwifery School, Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
2 Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
3 Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
4 Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
5 Lecturer in Pharmacoepidemiology and Pharmacy Practice, Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, UK

Abstract

Context: Depression is a highly prevalent and debilitating mental disorder, particularly among patients under hemodialysis, who are more susceptible to depression due to their complex treatment regimens, dietary limitations, side effects of medications and fear of disease outcomes. This systematic review and meta-analysis explored the prevalence of depression in Iranian hemodialysis patients.

Evidence Acquisitions: In this systematic review and meta-analysis, search was done in national and international databases, including SID, MagIran, Google Scholar, Web of Science, Medline (via PubMed), and Scopus from inception to March 2018. Key search terms included hemodialysis, renal replacement therapy, dialysis, end-stage renal disease, renal failure, depression and Iran along with all their possible combinations. Data were combined for metaanalysis using random effects model. Heterogeneity between studies was analyzed by I2 test, and data were analyzed by STATA (version 12) software.

Results: The included 24 articles had a sample size of 2941 participants; the overall prevalence of depression in hemodialysis patients in Iran was 56.8% (95% CI: 50.5-63). The results of the univariate meta-regression analysis showed no significant correlation between prevalence of depression and methodological quality of articles (P=0.524), duration of hemodialysis (P=0.885), publication year (P=0.116), mean age of participants (P=0.224) and sample size (P=0.194).

Conclusions: More than half of the hemodialysis patients in Iran suffer from depression. Given the overlap of depression symptoms with uremia in this group of patients, it is necessary to identify depression in these patients for early management and interventions.

Implication for health policy/practice/research/medical education:

Depression is common in patients undergoing hemodialysis, with an estimated prevalence of 56.8%. The presence of depressive symptoms could potentially decrease patient’s medication adherence and hence leads to increased morbidity and mortality. Therefore, it is necessary for the healthcare team to always consider the symptoms of depression in hemodialysis patients to identify people at early stages and thus plan appropriate management care plan for better and effective outcomes.

Please cite this paper as: Abdi A, Dalvand S, Vahedian-Azimi A, Ghanei Gheshlagh R, Kurdi A. Prevalence of depression among Iranian patients under hemodialysis: a systematic review and meta-analysis. J Nephropathol. 2018;7(4):224-232. DOI: 10.15171/jnp.2018.47.

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Submitted: 10 Jan 2018

Accepted: 03 Jul 2018
First published online: 20 Jul 2018
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