Abstract:

Introduction: Psychosocial distress such as anxiety and depression are prevalent among patients with chronic diseases such as Chronic Kidney Disease. They are highly overlooked and attribute at reducing End Stage Renal Disease patient’s quality of life.

Aim: The aim of this study was to investigate the prevalence and factors associated with anxiety and depression among Chronic Kidney Disease patients at Bugando Medical Centre.

Methods: This was a cross-sectional study where convenient sampling technique was used to patients with Chronic Kidney Diseases at Bugando Medical Centre: Mwanza Tanzania. Participants were recruited consecutively as from August 2020 to September 2020. Data was collected using the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 Scales for Dependant variables. Socio demographic, economic and disease related questionnaires was used for independent variables .The statistical analysis of the data was performed through STATA version 13.0 version. Multivariate logistics regression analysis was performed to all independent variables with p-value of <0.05 to get most predictable factors.

Results: Survey participants were a total of 376 CKD patients, 67.02% male and 32.98% females whereby 32.45% were CKD patients attending hemodialysis at Nephrology unit of BMC and 67.55% were CKD hospitalized and patients attending clinic at BMC but not undergoing hemodialysis. The overall prevalence of anxiety was 40.96% whereby 21.84 % of the participants had mild anxiety, 14.10% had moderate anxiety and 5.05% had severe anxiety. Regarding depression the overall prevalence was 73.93% whereby, 47.07% had mild depression, 15.16% were experiencing moderate depression, 10.37% had moderately severe depression and 1.3% were experiencing severe depression. In anxiety, the age group of 41-50 years, those who had not started dialysis treatment and those who could not perform their personal duties were statistically more likely to develop anxiety while participants without insurance and treatment supporters were statistically less likely to develop anxiety symptoms. In depression participants who could not perform their personal duties, those who were not affected by modification of lifestyle and those who were not sexually active were statistically less likely to develop depression.

Conclusion: The results showed higher prevalence of both anxiety and depression among CKD patients. Earlier screening and detection for those at risk is essential to reduce the burden of morbidity and mortality and improve the quality of life of these patients.

Limitations: COVID 19 pandemic whereby it was difficult getting participants, as they were not visiting the hospital in fear of contacting corona virus. The study was Cross sectional nature whereby causality could not be assessed/casual association between factors examined. Therefore there is need for longitudinal studies to establish the exact causal direction anxiety and depression and the investigated variables. To add on, the use of self-administered instruments and scales aimed for symptom measurement may have led to diagnostic overestimation.