Prevalence and Correlates of Depression in Patients with Chronic Kidney Disease: A Hospital-based Cross-sectional Study from Eastern India

Abstract

Background: Depression is a frequent yet under-recognised comorbidity in chronic kidney disease (CKD) and is associated with poorer adherence, accelerated functional decline, and increased mortality. Robust prevalence data from Indian non-dialysis and dialysis cohorts remain limited. The present study estimated the prevalence of depression and identified its sociodemographic and clinical correlates among adults with CKD attending a tertiary-care hospital in eastern India. Methods: A hospital-based cross-sectional study was conducted over 12 months and enrolled 250 consecutive adults (≥18 years) with CKD stages 2–5 (including those on maintenance haemodialysis). Depression was screened using the validated Hindi/Assamese version of the Patient Health Questionnaire-9 (PHQ-9), with a score ≥10 defining clinically significant depression. Sociodemographic, clinical, and biochemical variables were captured on a structured proforma. Associations were examined using chi-square and Student t-tests; independent correlates were identified by multivariable logistic regression. A two-sided p<0.05 was considered significant. Results: The mean age of participants was 54.3±13.6 years; 62.4% were male. The overall prevalence of depression (PHQ-9 ≥10) was 53.2% (95% CI: 46.9–59.4), with severe depression in 8.4%. Prevalence rose progressively from 22.2% in stage 2 CKD to 78.6% in patients on maintenance haemodialysis (p<0.001). On multivariable analysis, advanced CKD stage (adjusted OR [aOR] 3.42; 95% CI 2.04–5.73), female sex (aOR 2.18; 1.21–3.93), diabetes mellitus (aOR 2.04; 1.18–3.53), serum haemoglobin <10 g/dL (aOR 2.61; 1.49–4.57), serum albumin <3.5 g/dL (aOR 1.96; 1.10–3.49), and poor perceived social support (aOR 3.07; 1.71–5.51) were independent correlates of depression. Conclusion: More than half of the studied CKD cohort screened positive for clinically significant depression, with prevalence rising sharply with disease severity. Routine PHQ-9 screening should be integrated into nephrology care, particularly for patients with anaemia, hypoalbuminaemia, diabetes, or limited social support.