Patient-Reported Social Frailty and Its Relationship with Depression In End-Stage Renal Disease
DOI:
https://doi.org/10.53778/pjkd101335Keywords:
Depression, Frailty, Patient reported outcome measures, Quality of life, Renal Replacement TherapyAbstract
Background and Objectives: Due to the associated impact on quality of life, chronic kidney disease leads to the development of depression. This study was done to assess the relationship between social frailty and depression in End-Stage Renal Disease patients.
Materials and Methods: This study was conducted at the Combined Military Hospital Lahore, including patients aged> 13 years of either gender with ESRD. All patients were evaluated for depression using the Patient Health Questionnaire-9 and for frailty using the Social Frailty Index-7 questionnaire. The effect modifiers such as age, duration of dialysis, concern regarding serum creatinine, fear of disability, dialysis-associated fatigue, and haematological parameters were also assessed using binary logistic regression analysis.
Results: A total of 150 patients with a mean age of 56.93 ± 13.78 years were enrolled. Among these, 106 (70.6%) were males, 61 (40.67%) had diabetes mellitus, 71 (47.33%) often felt fatigued, 103 (68.67%) had unintentional weight loss, and 59 (39.33%) reported slight concern about serum creatinine levels. Frailty and depression showed a significant correlation (r = -0.305, p<0.001). Similarly, socially frail patients had markedly higher odds of depression (adjusted OR 105.74, 95% CI 13.38–835.00; p < 0.001) compared with non-frail individuals. Associations observed for education, income, fear of disability or death, unintentional weight loss, polypharmacy, and serum albumin were no longer significant after adjustment for confounders; however, fatigue frequency and concerns about serum creatinine levels remained significant.
Conclusions: Frailty, fatigue, and psychological concern about serum creatinine levels were independently associated with depression in ESRD patients
References
Vanishree RP, Shriharsha C, Joseph T, Natekar DS. Sleep Quality, Depression and Quality of Life among patients with Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD) a Comparative Study Conducted in Bagalkot. Sch J App Med Sci, 2025;13(2): 400-8.
GBD 2023 Kidney Failure with Replacement Therapy Collaborators. Global, regional, and national prevalence of kidney failure with replacement therapy and associated aetiologies, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet Glob Health. 2025;13(8):e1378-e1395.
Khan A, Cheema MF, Fatima R, Cheema SS, Butt Z, Gillani S, et al. Prevalence of Chronic Kidney Disease in a High-Risk Population in Urban Lahore, Pakistan: A Cross-sectional Study. Cureus. 2024;16(6):e63296. doi: 10.7759/cureus.63296.
Yip W, Ng SHX, Kaur P, George PP, Guan JHC, Lee G, et al. Risk factors for short-term all-cause mortality in patients with end stage renal disease: a scoping review. BMC Nephrol. 2024;25(1):71
Hakeem Ismael N, Omer Rashid A. Health-Related Quality of Life in End-Stage Renal Disease Patients and Healthy Individuals. Galen Med J. 2020;9:e1987.
Depression [Internet]. Who.int. [cited 2025 Dec 30]. Available from: https://www.who.int/health-topics/depression
Malik SI, Idrees MK, Khan R, Maqbool S, Rasool U, Din AF. Depression Among Dialysis Dependent end-Stage Renal Disease Patients: A Study from Tertiary Care Hospital in Bahawalpur. Pak Armed Forces Med J. 2023;73(SUPPL-1):S45-49.
Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752-62.
Bunt S, Steverink N, Olthof J, van der Schans CP, Hobbelen JSM. Social frailty in older adults: a scoping review. Eur J Ageing. 2017;14(3):323-34.
Odaci Comertoglu E, Ozturk Y, Hafizoglu M, Kahyaoglu Z, Cavusoglu C, Balci C, et al. The effect of social frailty on mental health and quality of life in older people: a cross-sectional study. Eur Geriatr Med. 2024;15(2):453-61.
Zhang Q, Zhou XH, Zhu Y, Chen L, Zhang YJ, Shi M. Prevalence and Associated Factors of Social Frailty in Older Patients on Maintenance Hemodialysis: A Multi-Centre Cross-Sectional Study. Ther Apher Dial. 2025;29(6):878-84.
Adejumo OA, Edeki IR, Sunday Oyedepo D, Falade J, Yisau OE, Ige OO, et al. Global prevalence of depression in chronic kidney disease: a systematic review and meta-analysis. J Nephrol. 2024;37(9):2455-72.
Nablawi RA, Alghamdi LS, Alshaikh AE, Alagha AM, Alharbi NT, Ali AH, et al. Quality of life and depression among chronic kidney disease patients: a tertiary care center cross-sectional study. Front Nephrol. 2025;5:1600296.
Copaja-Corzo C, Palomino-Guerra G, Machaca-Choque D, Miranda-Chavez B, Flores-Cohaila J. Anxiety and depression associated with social inequity indicators in patients with end-stage renal disease. Clin Epidemiol Glob Health. 2024;30:101853.
Pandey RK, Kumari S, Nand V. Prevalence of Anxiety and Depression in Patients of End-Stage Renal Disease (ESRD) On Hemodialysis: A Single Centre Study. Natl J Med Res. 2025;15(02):120-5
Elkheir HK, Wagaella AS, Badi S, Khalil A, Elzubair TH, Khalil A, et al. Prevalence and risk factors of depressive symptoms among dialysis patients with end-stage renal disease (ESRD) in Khartoum, Sudan: A cross-sectional study. J Family Med Prim Care. 2020;9(7):3639-43.
Bahall M, Legall G, Lalla C. Correction: Depression among patients with chronic kidney disease, associated factors, and predictors: a cross-sectional study. BMC Psychiatry. 2023;23(1):881
Misu Y, Katayama O, Lee S, Makino K, Harada K, Tomida K, et al. Reciprocal relationship between physical and social frailty among community-dwelling older adults. Arch Gerontol Geriatr. 2023;114:105066.
Qi X, Li J. The Relationship between Social Frailty and Depressive Symptoms in the Elderly: A Scoping Review. Int J Environ Res Public Health. 2022;19(24):16683
Jhamb M, Weisbord SD, Steel JL, Unruh M. Fatigue in patients receiving maintenance dialysis: a review of definitions, measures, and contributing factors. Am J Kidney Dis. 2008;52(2):353-65
Guerra F, Di Giacomo D, Ranieri J, Tunno M, Piscitani L, Ferri C. Chronic Kidney Disease and Its Relationship with Mental Health: Allostatic Load Perspective for Integrated Care. J Pers Med. 2021;11(12):1367
Muscat P, Weinman J, Farrugia E, Callus R, Chilcot J. Illness perceptions predict distress in patients with chronic kidney disease. BMC Psychol. 2021;9(1):75
Clarke AL, Yates T, Smith AC, Chilcot J. Patient's perceptions of chronic kidney disease and their association with psychosocial and clinical outcomes: a narrative review. Clin Kidney J. 2016;9(3):494-502.
Knapp CD, Horak K, Roetker NS, Fink A, Gao A, Johansen KL, et al. Depression Symptoms Do Not Worsen over Time in a Cohort of Patients with CKD: The Brain in Kidney Disease Study. Kidney360. 2025 ;6(4):627-35
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 MahRukh Riaz, Mahtab Asif, Muhammad Umar Rafique, Abdul Rehman Arshad, Muhammad Iqbal, Aimen Karamat
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
