A comprehensive systematic review of pharmacological and non-pharmacological depression interventions for patients on dialysis

Background: Depression affects 38%–80% of end-stage renal disease patients on dialysis, causing increased hospitalizations, treatment nonadherence, and mortality rates. While various interventions have been researched, a comprehensive assessment remains necessary to address the psychological burden...

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Main Authors: Ahyeon Cho, Tammy Tran, Laura Telfer, Ahmad Matarneh, Sundus Sardar, Nasrollah Ghahramani
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:SAGE Open Medicine
Online Access:https://doi.org/10.1177/20503121251353028
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author Ahyeon Cho
Tammy Tran
Laura Telfer
Ahmad Matarneh
Sundus Sardar
Nasrollah Ghahramani
author_facet Ahyeon Cho
Tammy Tran
Laura Telfer
Ahmad Matarneh
Sundus Sardar
Nasrollah Ghahramani
author_sort Ahyeon Cho
collection DOAJ
description Background: Depression affects 38%–80% of end-stage renal disease patients on dialysis, causing increased hospitalizations, treatment nonadherence, and mortality rates. While various interventions have been researched, a comprehensive assessment remains necessary to address the psychological burden effectively. Objective: To assess previous research from 2017 to 2023 on the efficacy of pharmacological and non-pharmacological interventions for depressive symptoms in this group. Methods: A systematic review was performed across PubMed, ScienceDirect, Clinical Key, and Web of Science. Citations for inclusion and abstract extraction were assessed and confirmed by two independent researchers. Inclusion criteria consisted of clinical trials, randomized controlled trials, and prospective studies written in English. We excluded studies that were review articles, case reports, or editorials, or did not examine antidepressants, exercise, or other mental health interventions in dialysis patients. To assess risk of bias, the Risk of Bias 2 and the Risk of Bias in Non-randomized Studies of Interventions tools were utilized. Depressive symptoms were measured using different scales. Results: Among 911 screened citations, 30 articles were included, involving 1815 participants across 17 countries. Publications on antidepressant medication ( n  = 4), exercise ( n  = 9), music therapy ( n  = 4), and psychotherapy ( n  = 13) were included. Conclusion: While interventions like antidepressants, intradialytic exercise, music therapy, and psychotherapy show potential for managing depression in dialysis patients, small sample sizes, lack of control groups, and short treatment durations continue to limit current studies. Future research should focus on multicenter trials with larger, more diversified populations and stronger study designs.
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spelling doaj-art-90e67c9e86a64fcd8fb4e14d73945fa32025-08-23T15:04:20ZengSAGE PublishingSAGE Open Medicine2050-31212025-08-011310.1177/20503121251353028A comprehensive systematic review of pharmacological and non-pharmacological depression interventions for patients on dialysisAhyeon Cho0Tammy Tran1Laura Telfer2Ahmad Matarneh3Sundus Sardar4Nasrollah Ghahramani5Pennsylvania State University College of Medicine, Hershey, PA, USAPennsylvania State University College of Medicine, Hershey, PA, USAPennsylvania State University College of Medicine, Hershey, PA, USADivision of Nephrology, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USADepartment of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USADivision of Nephrology, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USABackground: Depression affects 38%–80% of end-stage renal disease patients on dialysis, causing increased hospitalizations, treatment nonadherence, and mortality rates. While various interventions have been researched, a comprehensive assessment remains necessary to address the psychological burden effectively. Objective: To assess previous research from 2017 to 2023 on the efficacy of pharmacological and non-pharmacological interventions for depressive symptoms in this group. Methods: A systematic review was performed across PubMed, ScienceDirect, Clinical Key, and Web of Science. Citations for inclusion and abstract extraction were assessed and confirmed by two independent researchers. Inclusion criteria consisted of clinical trials, randomized controlled trials, and prospective studies written in English. We excluded studies that were review articles, case reports, or editorials, or did not examine antidepressants, exercise, or other mental health interventions in dialysis patients. To assess risk of bias, the Risk of Bias 2 and the Risk of Bias in Non-randomized Studies of Interventions tools were utilized. Depressive symptoms were measured using different scales. Results: Among 911 screened citations, 30 articles were included, involving 1815 participants across 17 countries. Publications on antidepressant medication ( n  = 4), exercise ( n  = 9), music therapy ( n  = 4), and psychotherapy ( n  = 13) were included. Conclusion: While interventions like antidepressants, intradialytic exercise, music therapy, and psychotherapy show potential for managing depression in dialysis patients, small sample sizes, lack of control groups, and short treatment durations continue to limit current studies. Future research should focus on multicenter trials with larger, more diversified populations and stronger study designs.https://doi.org/10.1177/20503121251353028
spellingShingle Ahyeon Cho
Tammy Tran
Laura Telfer
Ahmad Matarneh
Sundus Sardar
Nasrollah Ghahramani
A comprehensive systematic review of pharmacological and non-pharmacological depression interventions for patients on dialysis
SAGE Open Medicine
title A comprehensive systematic review of pharmacological and non-pharmacological depression interventions for patients on dialysis
title_full A comprehensive systematic review of pharmacological and non-pharmacological depression interventions for patients on dialysis
title_fullStr A comprehensive systematic review of pharmacological and non-pharmacological depression interventions for patients on dialysis
title_full_unstemmed A comprehensive systematic review of pharmacological and non-pharmacological depression interventions for patients on dialysis
title_short A comprehensive systematic review of pharmacological and non-pharmacological depression interventions for patients on dialysis
title_sort comprehensive systematic review of pharmacological and non pharmacological depression interventions for patients on dialysis
url https://doi.org/10.1177/20503121251353028
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