Rx Nutrition Resource Center
Rx Nutrition Resource Center
December 04, 2019
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Depressive symptoms common, linked to dietary non-adherence in patients on hemodialysis

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Researchers of a published study found a high prevalence of both depressive symptoms and dietary non-adherence in patients on hemodialysis and further observed a significant association between symptoms of depression and likelihood of not adhering to dietary recommendations.

“Extant research has found that depression is the most common mental comorbidity among ESRD patients, although prevalence rates vary widely across studies ranging from 20% to 90%,” Mignote Hailu Gebrie, BSN, MSN, of the University of Gondar in Ethiopia, and Jodi Ford, MSN, PhD, of Ohio State University, wrote. “Depressive symptoms also have been found to be associated with low adherence to prescribed dialysis treatments, including dietic recommendations that may result in increased morbidity and mortality. Despite these findings, depression remains underdiagnosed and understudied in ESRD patients.”

To build on the “inconsistent findings” of previous studies regarding the relationship between depressive symptoms and dietary non-adherence, the researchers reviewed 28 articles published between 2001 and 2016 (11 studies on depression and patient outcomes, 10 on dietary adherence and seven on the relationship between the two conditions).

The existing literature indicated depressive symptoms were associated with decreased quality of life and increased morbidity and mortality. Clinical variables, such as urea, hemoglobin, creatinine and serum albumin, were also found to be associated with depressive symptoms. In addition, the researchers saw a greater likelihood of depressive symptoms in patients who were younger, unemployed or who had decreased social support.

Woman sadly looking into refrigerator 
Researchers of a published study found a high prevalence of both depressive symptoms and dietary non-adherence in patients on hemodialysis.
Source: Adobe Stock

They further found age, social support, educational status, behavioral control and positive attitudes influenced likelihood of dietary adherence. Patients with depressive symptoms were more likely to be non-adherent.

Hailu Gebrie and Ford noted that the review uncovered discrepancies regarding the prevalence of depression and dietary non-adherence (rates ranging from 6% to 83.49% and 41.1% to 98.3%, respectively), suggesting this could be due to the diverse populations studied and varied self-reporting instruments.

“Despite the variation in [the] assessment tool applied, depressive symptoms and dietary non-adherence were highly prevalent in patients with ESRD receiving hemodialysis therapy,” they concluded. “Nearly all of the articles that examined the relationship between depressive symptoms and dietary non-adherence showed significant associations. Therefore, it is possible to recommend that early diagnosis and treatment of depression and close monitoring of adherence behavior are especially important in ESRD patients to improve their quality of life. Moreover, it will be important to consider both pharmacological and non-pharmacological (eg, social support) interventions to reduce depression in order to enhance adherence and improve survival rates.” – by Melissa J. Webb

Disclosures: The authors report no relevant financial disclosures.