Impact of depression on clinical outcomes of peritoneal dialysis: A systematic review and meta-analysis.

Objective: Depression has become a highly prevalent mental disorder around the globe. With a large number of end-stage renal disease patients taking up peritoneal dialysis (PD), a substantial number of PD patients with concomitant depression are expected to be treated in the future. However, the effects of depression on outcomes of PD are unclear. This review systematically examines the effect of depression on mortality, technique survival, or peritonitis in PD patients.

Materials and methods: Studies comparing outcomes of PD patients with and without depression and published on Google Scholar, Embase, Web of Science, and PubMed till February 5, 2024 were included.

Results: Eleven studies were eligible; 5 studies reported data on mortality. Pooled analysis showed that depression was not a significant predictor of mortality in PD patients (HR: 1.22 95% CI: 0.86, 1.72). Only 2 studies reported analyzable data on technique survival and 3 studies on peritonitis. Meta-analysis found no statistically significant effect of depression on technique survival (OR: 1.28 95% CI: 0.38, 4.35) and peritonitis (OR: 1.89 95% CI: 0.82, 4.33). Qualitative analysis of remaining studies also suggested no effect of depression on patient and technique survival.

Conclusion: Depression may not be an independent predictor of patient and technique survival in PD patients. Data on the risk of peritonitis is conflicting and needs to be investigated further.