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 R2 = .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 R2 = .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.