A Study on Depression, Anxiety and Quality of Life ofChronic Renal Failure Patients on Maintenance Hemodialysis.

Introduction: End stage renal disease is a condition marked by gradual Decrease in the function of both the kidneys from where no Improvement in renal function could be expectd and the patient will Have to depend on the dilayzing machines for the removal of the waste Products of the body on the regular basis. Treatment of this conditions Involves dietary adjustments, regular medications and regular dialysis Or renal transplantation. For several reasons, renal transplantation is not A easily available option. Patient may not be able to procure a stuitable Kidney, age and other medical conditions may debar the patient from That treatment option leaving him with the only option of regular Dialysis. Dialysis as a procedure, either hemodialysis or peritoneal Dialysis or other ambulatory dialysis methods involves several physical As well as psychological trauma that will lead to various psychiatric Illness which in turn imapairs the quality of life of these patients. The Patient will have to tolerate the loss of independence, dependence on The dialysis machines, rigorous drug regimens involving drugs like Multiviatamins, phosphate binders, calcium supplements, iorn Supplements, errthropoietin injections…etc, and not to forget the Financial burden. But even a good compliance to these treatment Procedures are not found to produce to a meaningful productivity and Quality of life. The “X” factor in most of these situations has been Identified as psychological impairments. Hence now adequate Programs has been put in place in several countries for the regular Screening for these impairments among ESRD patients. Depression has been identified as the most common psychiatric Disorder prevalent among this group of patients, and its role in causing Morbidity and mortality in these patients has been studied in detail. Old Age, pain, comorbid medical or surgical conditions, financial stresses, Poor social support, have been identified as few important factors that Predispose the patients to depression and other other psychological Impairments. Suicide is one feared outcome due to the presence of Depression among the ESRD patients. Though anxiety is also another Common condition but the impairment it causes on the final outcome in The patient is still under research. These along with other social and Psychological factors has been found to affect the overall quality of Life of these patients to a greater extent . The western countries are paying greater attention for the Identification and treatment of these psychcological impairments that Occur as comorbidity among ESRD patients. But studies among indian Population are very minimal. Several studies of this kind will have to Be conducted on the indian population, inorder to get a clear Perspective about the exact quantum of the problem as well as to show The improvement it can have on the ESRD population if these problems Are treated. SCOPE OF THE STUDY: Several studies on the prevalence of depression and anxiety has Produced results in a very broad range, ranging around 20% to 70%. Indian studies in this perspective are less compared to the quantum of Western studies. Hence a study on the prevalence of depression and Anxiety among the indian population and the various factors that are Found to have association with these psychological impairments will Give a better idea about the occurrence of these conditions among Indian ESRD patients. Again studying the quality of life of the ESRD Patients will give an idea about the subjective perception of well being In these patients and a possibility to identify the areas where Intervention could be planned in the future to improve their quality of Life.