Depression in ESRD Patients: Home HD is Less Depressive than In-Center HD

Background: Depression is a common, under-recognized and under-treated problem that is independently associated with increased morbidity and mortality in patients with chronic kidney disease (CKD). However, there has been a paucity of simple reliable methods to evaluate the severity of depressive symptoms. Recently the 16-item Quick Inventory of Depressive Symptomatology (QIDS), a new measure of depressive symptoms became available and validated for the evaluation of severity of depression. Until now, there have been no decisive reports in evaluating depression in comparing two dialysis modalities for treatment for patients with end-stage renal disease (ESRD) Methods: We used this questionnaire to examine the patients with ESRD. Patients: One hundred and twenty four patients undergoing in-center hemodialysis (HD) (65 years; m/f: 75/52), and 45 patients on home HD (HHD) (54 years; m/f: 40/5) were enrolled. Results: The prevalence of moderate depressive symptoms (more than 11 points of the score) was higher (11%) in HD patients than (4%) in HHD (P<0.01). Among the 16 questionnaires three items: sleep during the night, energy level, and slowed down feeling were significantly less severe in HHD patients than in HD patients. Conclusion: We conclude that prevalence of depression was high in patients receiving dialysis therapy. It is suggested that HHD therapy is superior to HD for patients with end stage renal disease in psychological aspects.