Impact of Psychosocial Interventions on Depression in Chronic Kidney Disease: A Systematic Review and Meta-Analysis.
Jivitesh Singh Chahal, Sumit Saini, Priyanka Bansal et al.
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In 30 seconds
This systematic review and meta-analysis assessed psychosocial interventions for depressive symptoms in people with stage 4 or 5 chronic kidney disease or receiving hemodialysis. It included 12 randomized controlled trials with 792 participants; cognitive-behavioral therapy was the most common intervention. Compared with routine care, psychosocial interventions reduced depressive symptoms (mean difference [MD]: -4.22; 95% CI: -6.67, -1.76; P = 0.0008). The analysis found high heterogeneity (I 2 = 89%). Quality of life did not improve significantly.
Key findings
- Across 12 trials and 792 participants, interventions reduced depressive symptoms versus routine care (MD: -4.22; 95% CI: -6.67, -1.76; P = 0.0008).
- Results for depressive symptoms showed high heterogeneity (I 2 = 89%), although sensitivity analysis supported their robustness.
- Quality of life did not improve significantly (MD: 0.94; 95% CI: -0.61, 2.49; P = 0.24).
- The review rated the evidence for reducing depressive symptoms as moderate quality.
Why it matters
Depressive symptoms are an important concern in advanced CKD and dialysis. This synthesis suggests psychosocial approaches can reduce symptoms compared with routine care, while also showing that improvement in quality of life was not demonstrated. The high heterogeneity indicates that effects may vary across interventions or study settings, so the pooled result should be interpreted with that variability in mind.
What to keep in mind
The pooled estimate had high heterogeneity (I 2 = 89%), and the included population was limited to stage 4 or 5 CKD or hemodialysis.