Chronic kidney disease (CKD) is the deterioration of kidney functions to the extent that they cannot filter blood normally.
As chronic kidney disease progresses, dangerous levels of fluids, electrolytes, and waste products build up in the body, leading to nausea, vomiting, loss of appetite, decreased mental energy, high blood pressure, etc.
Signs and symptoms of kidney disease are often not specified. This means that other conditions can also cause it. Because the kidneys can compensate for lost function, symptoms may not appear until irreversible damage has occurred.
Depression consists of symptoms where the person has a persistently low mood or loss of interest in daily activities that cause significant impairment in the individual’s daily functioning. The symptoms of depression should persist for six months or more for a justified diagnosis to be made.
Anxiety is the constant and excessive worrying that an individual can suffer from which causes them to be apprehensive about every situation encountered. It can affect the individual’s overall health and mental well-being.
The World Health Organization has defined quality of life as ‘the way you perceive your position in life in the background of the culture and values โโin which you live concerning your goals, expectations, and standardsโ.
Little research has been done on the entity of CKD in Jordan, especially due to the lack of a consolidated database or registry. No recent studies have examined the mental health of CKD patients in Jordan or the region.
The study aimed to understand the prevalence and Quality of Life perceptions of depression and anxiety in a sample of CKD patients from the Jordan University Hospital (JUH) and to assess their correlation to the sociodemographic or laboratory and metabolic profiles of this population.
Data were collected between June 2018 to March 2020 from CKD patients (stages I-V) aged 18 years and above. The exclusion criteria were patients under the age of 18 , cognitively impaired, pregnant women, and patients with last-stage renal disease (ESRD) who require dialysis.
A total of 103 patients participated by giving informed consent and were interviewed using a questionnaire in the nephrology outpatient clinics of the Jordan University Hospital. The questionnaire administered consisted of four sections.
The first section covered sociodemographic data such as gender, age, marital status, occupation, and level of education, as well as the medical records of individual JUH patients.
The second part consisted of the Patient Health Questionnaire (PHQ-9), which measures the severity of depression.
The third part included the 7-item Generalised Anxiety Disorder (GAD-7) to assess the severity of anxiety.
In part four, the participant’s quality of life was assessed using the World Health Organization Overview of Quality of Life Questionnaire (WHOQOL-BREF), comprising 26 questions grouped into four domains: physical, psychological, social relationships, and environment.
Statistical data was entered and analysed using the Statistical Package for the Social Sciences (SPSS) version 25.
The study revealed a high prevalence of anxiety and depression among CKD patients attending the nephrology clinics at JUH.
Furthermore, a positive correlation was found between anxiety and QoL domains, meaning anxiety scores increase as the QoL scores decrease. Depression and anxiety were also found to be negatively correlated with Quality of Life.
Regarding sociodemographic variables, the study found that education and work influence the quality of life, especially in the physical domain.
In conclusion, mental health is an essential component of overall well-being. Unfortunately, psychiatric disorders such as depression and anxiety are usually underestimated or not diagnosed.
Patients with comorbidities, including CKD, are prone to psychological distress. Implementing a screening program or tool as part of follow-up visits can help detect and diagnose psychiatric disorders such as depression and anxiety.
