الفهرس 
Chronic Kidney Disease and HemodialysisOnly 14 pages are availabe for public view
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Abstract
Major depressive disorder (MDD) is a mental disorder characterized by episodes of all-encompassing low mood accompanied by low self-esteem and loss of interest or pleasure in normally enjoyable activities. According to WHO’s criteria for depression, a depressed person may report multiple physical symptoms such as fatigue, headaches, or digestive problems; physical complaints are the most common presenting problem in developing countries Depression is prevalent in patients with CKD and has been associated with increased morbidity and mortality. Whereas, the point prevalence of depression in US is from 2% - 4% in the general community and 5% - 10% in the primary care setting, 20% - 30% of patients with CKD have clinical depression. Symptoms of clinical depression affect approximately 25% patients on haemodialysis and can be associated with low quality of life and increased mortality. This a cross-sectional study aimed to determine the prevalence of depression and to evaluate the association between this disorder and demographic, clinical and biochemical parameters of ESRD Egyptian patients on maintenance hemodialysis (HD). All patients in this study were subjected to Full history taking, etiology of ESRD, Assessing social status, stresses, drug history and comorbidities, Complete clinical examination, Mini-mental state examination, Social class examination and The patients will filled out the Beck’s Depression Inventory questionnaire (12).Among 100 patients, 80 were depressed and 20 were non-depressed with mean value of BDI score was 23.84 ± 11.30. The mean age was significantly higher in cases with depression than non-depressed group (46.93 ± 9.12 versus 39.15 ± 11.44, p=0.009). In current study, there was no significant correlation between the two studied groups regarding presence of diabetes or types of dialysis, HIV, Hepatitis B &C virus, serum calcium, phosphorus and iPTH (p= 0.551, 1.000, 0.551, 0.163, 0.716, 0.442 & 0.883 respectively). We found a significant increase in dialysis vintage among group with depression (6.82 ± 3.97) than those without depression (4.25 ± 4.08) as (P value= 0.004). In this study, the depressive patients (1.13 ± 0.21) had significantly lower dialysis adequacy than those without depression (1.42 ± 0.13) as (p=<0.001). The majority of our patients (98.8%) in depressive group had no cognitive impairment versus (100%) in patients without depression without significant difference between both groups (p=1). The mean value of MMSE (Mini-Mental State Examination) was 27.87 ± 1.96 in depressive group than those without depression (28.50 ± 1.54) without significant difference between both groups (p=0.175). The majority of our patients (51%) in depressive group were belong to medium socioeconomic, (47.5%) were belong to low socioeconomic status without significant difference between both groups (p=0.157). the median value of SSE (Social Status.Examination) 40.0 in depressive group and those without depression 44.50 without significant difference. As regard as, serum ferritin, hemoglobin level and albumin significantly decreased in the presence of depression (P value=0.023, p <0.001 & <0.001 respectively) with a strong significant difference in TSAT% (P value <0.001) in both groups with and without depression respectively.