Depression, Anxiety, and Quality of Life among Hemodialysis Patients with Chronic Kidney Disease: A Systematic Review

Abstract

Chronic kidney disease (CKD) is a major global health concern, with hemodialysis serving as the primary treatment for patients with end-stage renal disease (ESRD). Although life-sustaining, hemodialysis often imposes substantial psychological and physical burdens that adversely affect patients' quality of life (QoL). This systematic review examined the association between depression, anxiety, and QoL among hemodialysis patients with CKD. A comprehensive literature search was conducted in PubMed, Google Scholar, ProQuest, SciELO, LILACS, and Embase for studies published between January 2018 and July 20, 2023. Of the 3,025 records identified, 20 studies involving 5,209 hemodialysis patients met the inclusion criteria. The prevalence of depression ranged from 5.52% to 76%, indicating considerable variability across study populations but highlighting depression as a common psychological problem. Most studies consistently reported a significant negative association between depression and QoL, with reported p-values ranging from <0.001 to 0.1, demonstrating that greater depressive symptoms were associated with poorer overall wellbeing. The findings emphasize the need for routine psychological assessment and timely interventions to improve mental health and QoL in this population. Further large-scale, multicenter studies are required to clarify these relationships and support the development of effective, evidence-based strategies for improving patient outcomes and informing clinical practice and health policy.