THE EFFECTIVENESS OF DIETARY INTERVENTION IN ALLEVIATING DEPRESSION IN PATIENTS ON MAINTENANCE HEMODIALYSIS

Introduction:

The prevalence of depression in patients on maintenance hemodialysis (MHD) has been reported to be as high as 20% to 90%. This high risk of depression is generated by stressors, including physical, financial, occupational, social, and dietary, all of which add to the patient’s already overburdened mental makeup. One significant but potentially modifiable stressor is dietary restriction. A recent study done on patients with MHD at Apex Kidney Care (AKC) evaluated the extent of depression using a PHQ-9 questionnaire and identified food restriction as one of the modifiable risk factors associated with depression.

Methods:

This study was an extension of the previous research where focussed and personalised dietary counselling was performed on the subset of patients with significant depression, i.e., a PHQ-9 score≥ 10, and a second PHQ-9 questionnaire evaluated its effect on depression.

A total of 60 patients with significant depression (PHQ-9 scores ≥ 10 )from the previous study were followed up. Thirty-five patients from that cohort who were available and consenting received personalised dietary counselling for six weeks, including tailored diet charts based on their medical condition and food preferences. Follow-up dietary recall was taken every 15 days to understand their compliance with the diet charts provided to them. After six weeks, a follow-up PHQ-9 assessment was administered.

Results:

Among the 60 patients from the previous study, four had passed away, ten had exited the centre, six had received kidney transplants, and five had not provided consent. For the remaining 35 patients, the median PHQ-9 score before dietary consultation was 13 (IQR: 12-15). Following the dietary intervention, the median PHQ-9 score decreased to 8 (IQR: 4.5-11). The minimum PHQ-9 score improved significantly from 10 to 1, while the maximum score decreased from 27 to 23, indicating an overall reduction in the severity of depression among these patients. The Wilcoxon signed-rank test showed a statistically significant reduction in depression scores post dietary intervention (p < 0.0001).

Conclusions:

Since dietary restriction is a known stressor in patients with MHD, modifying this with tailored dietary counselling and follow-up can play a very effective role in alleviating depression.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.