A Comparative Study of Depression and Insomnia among Patients on Continuous Ambulatory Peritoneal Dialysis versus Hemodialysis.

BACKGROUND

Depression and insomnia are common yet under-recognized comorbidities in end-stage kidney disease (ESKD) patients on dialysis. Comparative data on their prevalence between hemodialysis (HD) and peritoneal dialysis (PD) are limited.

OBJECTIVES

To compare the prevalence and severity of depression and insomnia in patients undergoing HD and PD and identify clinical and biochemical correlates.

MATERIALS AND

METHODS

A multicenter, cross-sectional study was conducted across armed forces hospitals in Northern India from November 2024 to January 2025. Adult ESKD patients on HD or PD were assessed using the Patient Health Questionnaire-9 (PHQ-9) for depression. Insomnia was assessed using a response to a battery of questions. Demographic, clinical, and laboratory data were analyzed.

RESULTS

Of 188 patients screened (HD 105, PD 83), 51 HD (48.6%) and 37 PD (44.6%) patients had PHQ-9 scores ≥5, indicating depression. Most had mild depression (HD 25.7%; PD 22.6%). Moderately severe depression was present in a small number, with no difference between the dialysis modalities. Insomnia prevalence was comparable (HD 24.7%; PD 22.6%). Severe depression was associated with lower hemoglobin and albumin, especially in PD (albumin: 2.38 vs 3.10 gm/dL, p = 0.03).

CONCLUSION

Depression and insomnia are highly prevalent but underrecognized in dialysis patients. Dialysis modality did not affect the prevalence of depression or insomnia. Lower hemoglobin and albumin correlate with severe depressive symptoms.