Prevalence of Depression in Hemodialysis Patients: A Meta‐Analysis

INTRODUCTION: Depression is the third most disabling disease worldwide and is prevalent in patients undergoing hemodialysis. Given the greatly varied prevalence of depression in different regions, this meta-analysis was conducted to elucidate the status of depression in hemodialysis patients. METHODS: PubMed, Embase, Cochrane Library, and Web of Science databases were searched for relevant literature on depression in hemodialysis patients from inception to July 2023. Subgroup analyses and meta-regression were subsequently performed to determine the source of heterogeneity. RESULTS: A total of 137 cross-sectional studies were included, involving 21,608 hemodialysis patients. The random-effects analyses demonstrated that the prevalence of depression was 45.8% in hemodialysis patients (95% confidence interval [CI]: 42.0%-49.6%). Subgroup analysis of national income levels implied that high-income countries had the lowest prevalence of depression at 38.9% (95% CI: 34.1%-43.7%). Studies with a higher proportion of female hemodialysis patients reported a relatively higher prevalence of depression. Subgroup analysis by age revealed that patients under 40 years old had a depression prevalence of 50.8% (95% CI: 25.6%-76.0%), which was higher than that of other age groups. Different self-rating depression scales yielded different prevalence of depression in hemodialysis patients. CONCLUSION: Depressive symptoms are common in hemodialysis patients, so screening and identifying those at risk for depression and developing effective intervention strategies are of great value.