Psychological Distress and Predictors of Anxiety and Depression in New Hemodialysis Patients

Background: Patients initiating hemodialysis experience substantial lifestyle changes that increase their risk of psychological distress, including anxiety and depression. Despite these challenges, the existing literature has primarily focused on long-term hemodialysis populations, with limited research examining psychological distress during the early stages of hemodialysis treatment. Aim: To assess levels of anxiety and depression among newly diagnosed CKD patients beginning hemodialysis and to identify demographic and clinical predictors of psychological distress. Methods: A cross-sectional survey was conducted with 50 adults initiating hemodialysis within the first year of dialysis treatment at the Kidney Care Centre in St. John's, NL. Data were collected using a demographic questionnaire and the Hospital Anxiety and Depression Scale (HADS). Descriptive and multiple regression analyses were performed. Results: High prevalence of psychological distress was observed. Anxiety was reported in 67.4% of participants (M = 11.41, SD = 2.32), while 60.9% were borderline and 8.7% clinically depressed (M = 8.52, SD = 1.99). Predictors did not significantly explain anxiety (Adjusted R 2 = .127, p = 0.11), though shorter dialysis duration (1–6 months) was associated with higher anxiety (p = 0.01). Depression was significantly predicted by employment status (Adjusted R 2 = .277, p = 0.019), with employed patients reporting higher scores. Conclusion: Newly initiated hemodialysis patients experience substantial anxiety and depression, particularly in the early treatment period. Early psychological screening, structured orientation programs, and person-centered coping interventions tailored to individual occupational and social contexts are recommended to support mental health and treatment adherence.