Psychosocial strategies for easing depression in chronic kidney disease

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Created On: 29/07/2025

Depression is commonly observed in chronic kidney disease (CKD) sufferers, particularly those undergoing dialysis, and is linked to increased morbidity and mortality.

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Key take away

In chronic kidney disease patients, especially those on dialysis, psychosocial therapies reduce depression but have limited impact on overall quality of life.

Background

Depression is commonly observed in chronic kidney disease (CKD) sufferers, particularly those undergoing dialysis, and is linked to increased morbidity and mortality. This systematic review and meta-analysis sought to explore the effectiveness of psychosocial interventions in alleviating symptoms of depression in such patients.

Method

Following PRISMA guidelines, a comprehensive literature search was carried out in PubMed, Embase, Google Scholar, and the Cochrane Library. Included studies were randomized controlled trials (RCTs) that examined psychosocial interventions in CKD patients at stage 4 or 5 or those receiving hemodialysis. The key outcome was the change in depressive symptoms, assessed via validated clinical scales. Quality of life was the secondary outcome ascertained.

Result

Overall, 12 RCTs involving 792 volunteers (420 in the intervention group and 372 in the control group) fulfilled the inclusion criteria. Cognitive-behavioral therapy (CBT) was reported to be the most frequently studied intervention. Compared to usual care, psychosocial interventions led to a remarkable reduction in depressive symptoms (mean difference [MD]: −4.22). However, heterogeneity across studies was high (I² = 89%). Sensitivity analyses favored the stability of these outcomes. No remarkable improvement was observed in quality of life (MD: 0.94).

Conclusion

Moderate-certainty evidence indicated that psychosocial interventions are beneficial in easing depressive symptoms in CKD patients. Despite the lack of notable quality of life improvement, these interventions serve as a viable alternative to medications, potentially lowering the incidence of drug-related adverse effects.