Financial Burden and Psychological Impact on Patients and Family with Chronic Kidney Disease on Haemodialysis: A Cross-sectional Study in Rural Bangladesh

Introduction: Chronic kidney disease (CKD) impacts around 10% of people globally while in Bangladesh the rate is 22.48% which marks a significantly higher rate than the global scale. Hemodialysis is one of the most impactful treatments for end-stage renal disease, is somewhat costly for a nation like Bangladesh where 73% of healthcare costs are borne out-of-pocket. Patients who undergo hemodialysis face economic challenges and psychological stress. This study explored the financial strain and mental health consequences faced by CKD patients while receiving hemodialysis treatment in Bangladesh. Methods: This cross-sectional study was carried out at Kumudini Hospital in Tangail during September and October 2024, for the purposeful sampling to collect data of 40 CKD patients who received regular hemodialysis. We used a standard questionnaire for collecting data, utilizing demographic characteristics, economic costs, and mental health status via the Generalized Anxiety Disorder 7 (GAD-7) scale, evaluated both before and after dialysis sessions. The statistical analysis involved descriptive information, Chi-square tests, and Spearman's correlation to identify relationships between economic costs and mental health scores. Result: CKD primarily affects middle-aged individuals (75% of patients aged 40-69 years old) and predominantly women (57.5%). The frequency of unemployment following dialysis saw a significant increase, rising from 5% to 32.5%, while average income fallen by 77.2% (from 9,007 to 2,050 BDT). Monthly dialysis costs were more or less 19,425 BDT, with relatives (35%) and family members (27.5%) serving as the main sources of financial aid. A decline in mental health status was observed post-dialysis, with moderate anxiety increasing from 10% to 35%. Notable positive correlations were found amid post-dialysis anxiety and factors such as reduced income (p=0.02), dependency on relatives (p=0.04), and employment status (p=0.03). Conclusion: Hemodialysis therapy imposes a substantial financial burden and psychological stress on patients with CKD in Bangladesh, revealing a strong relationship between economic challenges and declining mental health. These results underscore the necessity for robust support systems that encompass both financial aid and psychological care for this at-risk group. ; , , ,