An Integrative Review of Depression in Patients Receiving Hemodialysis for End-stage Renal Disease and the Relevance to Patients With Wounds.

End-stage renal disease (ESRD) often is treated with hemodialysis, which carries significant psychological impact along with risks for wound development. Depression is a constant concern.

PURPOSE: An integrative review was conducted to examine studies regarding depression in adults receiving hemodialysis for ESRD.

METHODS: PubMed and the Cumulative Index for Nursing and Allied Health Literature were searched for English-language publications from 2012 to 2017 regarding ESRD using the search terms epidemiology, hemodialysis, and depression and hemodialysis, depression, nocturnal, and wounds, respectively.

RESULTS: Eight (8) of 152 articles found met the inclusion criteria and were categorized thematically. Depression was noted to affect 9.3% to 83% of persons receiving hemodialysis for ESRD. The occurrence of depression does not change across the course of ESRD. Although no publications on patients that included all search terms were found, ESRD and hemodialysis were noted to be independent risk factors for ulcer development, poor healing, and amputation. Wounds can be another source for risk of depression.

CONCLUSION: Although the literature does not include studies that contain all components, ESRD, depression, and wounds are linked. Depression is a common occurrence in patients with ESRD and dialysis. Examining the effect of wounds on depression for these patients is critical. As such, additional research is warranted to explore the interconnections of ESRD, depression, and wounds to improve clinician awareness and patient outcomes.