Abstract
BACKGROUND: Depression is a common mental disorder in hemodialysis patients. The present study aimed to identify subgroups of patients receiving hemodialysis based on depression and explore the influencing factors in a multicenter hemodialysis population in China. METHODS: A total of 1,090 hemodialysis patients (682 men, mean aged 61.5 ± 12.6 years) from 7 facilities in Shanghai of China during 2020-2023. Depression was assessed by Patient Health Questionnaire 9 (PHQ-9). Latent class analysis (LCA) was performed to identify homogeneous groups of depressive symptoms. Analysis of variance and chi-square test were performed to establish class-dependent differences in depression severity. Multinomial logistic regression revealed the associations and related factors on most probable class. RESULTS: Three latent classes were identified: High depressive symptoms (Class 1, N = 130, 11.9%), Moderate depressive symptoms (Class 2, N = 424, 38.9%) and Low depressive symptoms (Class 3, N = 536, 49.2%). The multinomial logistic regression results indicated that compared with the Class 3, the factors influencing depression in the Class 1 and Class 2 were age, body mass index (BMI), fall history, malnutrition and Charlson Comorbidity Index (CCI) in patients undergoing hemodialysis. CONCLUSIONS: The current study provides evidence for the heterogeneity of depression severity. A better understanding of depression risk factor profiles could help develop targeted prevention and intervention programs for the hemodialysis population.