Prevalence of Depression Among Patients With Chronic Kidney Disease (Ckd) at the Kenyatta National Hospital

Abstract

Study background: Depression is a common co-morbidity among patients with Chronic Kidney Disease (CKD). Preceding studies indicates that this condition causes increased mortality and is also linked to poor quality of life. Nevertheless in Kenya, there is a scarcity of data on the prevalence of depression in CKD patients. Broad objective: The study aimed to establish the occurrence of depression among patients with Chronic Kidney Disease in Kenyatta National Hospital in Kenya. Study design and site: The study was carried out at the Kenyatta National Hospital in Kenya. It is one of the national referral hospitals in the country, situated in Nairobi, the capital city of Kenya. The study was done at the renal unit and general medical wards of the hospital and was a cross-sectional descriptive study. Participants and method: The study enrolled 289 patients with CKD who met the inclusion criteria on follow up for kidney transplant and dialysis at the renal unit, those on outpatient follow up at the renal clinic and patients with CKD admitted in the medical wards. The participants were enrolled using systematic random sampling. They were then interviewed using a researcher designed socio-demographic questionnaire with clinical characteristics and the Beck Depression Inventory-II. Data management: Data was keyed into a password confined Kobo Toolbox Database. IBM Statistics Software Version 21 was used to analyze data and the results reported in narratives, tables and charts. Results: The research had a sample size of 289 participants. 169(58.5%) of the participants were male while 120 (41.5%) were female. Study participants had a mean age of 45.9 years. The prevalence of depression (borderline clinical depression to extreme depression) was found to be 28.4%. 24.9% of participants had mild mood disturbances and 46.7% did not have depression. The most common symptoms of depression among the participants were loss of energy as reported by 78.5% of them and increased fatigue which was reported by 77.9% of the research participants. Lower education levels (p=0.007) was positively reported to be related to higher depression scores. Moreover, those who were not employed were at a higher risk of depression (p=0.031). There was also noted to be a considerable relationship amid the existence of other physical illnesses and depression (p=0.005). Further investigation on other physical illnesses revealed that hypertension was positively correlated with having depression (p=0.008). Conclusion: There is a high prevalence of depression among patients with CKD. Recommendations: Patients should be managed effectively for CKD and any other co-existing comorbidity to improve their health outcomes. Health care workers managing patients for CKD need to be keen to look for depression in them and manage it to give holistic care. There is a need to come up with local guidelines on how to effectively manage CKD patients who also have depression in our country Kenya to improve their quality of life.