title: Association of depression and anxiety with reduced quality of life in patients with predialysis chronic kidney disease.
abstract: OBJECTIVE
  Although depression and anxiety are the most common psychological problems among dialysis patients, little is known about the association between depression, anxiety and quality of life (QOL) in patients with predialysis chronic kidney disease (CKD). Therefore, we assessed the prevalence of depression and anxiety, and their association with QOL in patients with predialysis CKD.
  
  
  METHODS
  Two hundred and eight predialysis patients (male 61.1%) with a mean age of 55.7 ± 13.7 years and an estimated glomerular filtration rate < 60 ml/min/1.73 m(2) were enrolled. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. Patients with anxiety and depression scores ≥ 8 were diagnosed with anxiety and depression disorders respectively. The WHOQOL-BREF questionnaire was used to assess patient QOL.
  
  
  RESULTS
  The prevalence of depression (47.1%) and anxiety (27.6%) did not differ across CKD stages. Depression correlated positively with age, employment, income, education, comorbidity index, haemoglobin level, albumin concentration and anxiety score, and negatively with all WHOQOL-BREF domain scores. Anxiety correlated significantly with QOL, but not with socioeconomic factors. In a multiple regression analysis, haemoglobin level, anxiety and QOL were independent factors associated with depression. In a linear regression analysis, depression and anxiety independently correlated with QOL after we adjusted for age, alcohol use, employment, income, education, haemoglobin level and albumin concentration.
  
  
  CONCLUSIONS
  Patients with predialysis CKD have a high prevalence of depression and anxiety, which are associated with reduced QOL. Early detection of depression and anxiety and active interventions should be considered to improve the QOL of these patients.
authors.affiliation: Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Lee
authors.forename: M S
authors.initials: MS
authors.lastname: Kim
authors.forename: S
authors.initials: S
authors.lastname: Cho
authors.forename: S R
authors.initials: SR
authors.lastname: Kim
mesh_terms: D000367:Age Factors; D001008:Anxiety Disorders / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000523:psychology*; D012959:Socioeconomic Factors