Context: Depression is a highly prevalent and debilitating mental disorder, particularly among
patients under hemodialysis, who are more susceptible to depression due to their complex
treatment regimens, dietary limitations, side effects of medications and fear of disease
outcomes. This systematic review and meta-analysis explored the prevalence of depression in
Iranian hemodialysis patients.
Evidence Acquisitions: In this systematic review and meta-analysis, search was done in national
and international databases, including SID, MagIran, Google Scholar, Web of Science,
Medline (via PubMed), and Scopus from inception to March 2018. Key search terms included
hemodialysis, renal replacement therapy, dialysis, end-stage renal disease, renal failure,
depression and Iran along with all their possible combinations. Data were combined for metaanalysis
using random effects model. Heterogeneity between studies was analyzed by I2 test,
and data were analyzed by STATA (version 12) software.
Results: The included 24 articles had a sample size of 2941 participants; the overall prevalence
of depression in hemodialysis patients in Iran was 56.8% (95% CI: 50.5-63). The results of
the univariate meta-regression analysis showed no significant correlation between prevalence
of depression and methodological quality of articles (P=0.524), duration of hemodialysis
(P=0.885), publication year (P=0.116), mean age of participants (P=0.224) and sample size
Conclusions: More than half of the hemodialysis patients in Iran suffer from depression. Given
the overlap of depression symptoms with uremia in this group of patients, it is necessary to
identify depression in these patients for early management and interventions.