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Review
. 2025 Apr 28;15(5):179.
doi: 10.3390/jpm15050179.

Comparison of Depression in Hemodialysis, Peritoneal Dialysis, and Kidney Transplant Patients: A Systematic Review with Meta-Analysis

Gloria M Zaragoza-Fernández  1 , José C De La Flor  1   2 , Verónica Fernández Abreu  1 , Elisa Iglesias Castellano  1 , Laura Rodríguez-Barbero Requena  1 , Rafael Fernández Castillo  3
Affiliations
Review

Comparison of Depression in Hemodialysis, Peritoneal Dialysis, and Kidney Transplant Patients: A Systematic Review with Meta-Analysis

Gloria M Zaragoza-Fernández et al. J Pers Med. .

Abstract

Background: Depression is a common comorbidity in patients with chronic kidney disease undergoing renal replacement therapy. This meta-analysis compares depression prevalence across hemodialysis, peritoneal dialysis, and kidney transplantation, considering mean age, treatment duration, comorbidities (diabetes and hypertension), and measurement instruments. Methods: A systematic review and meta-analysis of 16 studies involving 26,301 participants was conducted in accordance with PRISMA guidelines and registered in PROSPERO. It analyzed observational studies (2000-2024) on depression in patients receiving hemodialysis, peritoneal dialysis, or kidney transplantation. Data extraction included sample size, mean age, treatment duration, comorbidities, and measurement instruments. Random-effects models calculated the standardized mean differences and pooled prevalence estimates. Heterogeneity (Cochran's Q, I2) and publication bias (Egger's test) were assessed. Results: Depression prevalence was 35.56% (95% CI: 34.2-37.0%) in hemodialysis, 35.09% (95% CI: 33.5-36.7%) in peritoneal dialysis, and 25.33% (95% CI: 24.0-26.6%) in kidney transplant recipients. No significant differences were found between hemodialysis and peritoneal dialysis. Mean age, treatment duration, comorbidities, and measurement instruments were not significantly associated with depression prevalence. Conclusions: Kidney transplantation is linked to a lower depression prevalence than dialysis, while no significant differences exist between hemodialysis and peritoneal dialysis. These findings highlight the need to ensure timely transplantation access and enhance psychological support for dialysis patients. Further research should explore psychosocial factors and targeted interventions to improve mental health in this population.

Keywords: depression; hemodialysis; peritoneal dialysis; renal replacement therapy; renal transplantation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.
Figure 2
Figure 2
Funnel plot chart for depression–hemodialysis.
Figure 3
Figure 3
Funnel plot chart for depression–peritoneal dialysis.
Figure 4
Figure 4
Funnel plot chart for depression–kidney transplantation.
Figure 5
Figure 5
Funnel plot chart for depression–HD, PD, and KT.
Figure 6
Figure 6
Funnel plot—hemodialysis.
Figure 7
Figure 7
Funnel plot—peritoneal dialysis.
Figure 8
Figure 8
Funnel plot—kidney transplantation.
Figure 9
Figure 9
Funnel plot—HD, PD, and KT.
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