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Abstract

Objectives: Patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis experience a substantial psychological and cognitive burden. This study aimed to determine the prevalence of major depressive disorder (MDD) and examine its association with cognitive impairment among patients receiving hemodialysis. Materials and Methods: A cross-sectional study was conducted among 30 consecutive patients aged 18–65 years undergoing maintenance hemodialysis at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Major depressive disorder was diagnosed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), with cognitive impairment defined as a MoCA score < 26. Demographic and clinical data were collected. Group comparisons were performed using independent sample t-tests, and logistic regression analysis was used to identify independent predictors of cognitive impairment. Results: The study included 18 men (60%) and 12 women (40%). The prevalence of MDD among the study population was 26.7% (n = 8). Patients with MDD had significantly lower mean MoCA scores compared with non-depressed patients (24.6 ± 3.9 vs. 26.9 ± 3.5; p = 0.01). Logistic regression analysis demonstrated that the presence of MDD was the strongest independent predictor of cognitive impairment (odds ratio = 3.21, 95% confidence interval: 2.08–5.11; p = 0.006). Conclusions: Major depressive disorder is common among patients undergoing hemodialysis and is strongly associated with cognitive impairment. Routine screening for depression and cognitive dysfunction should be incorporated into the clinical care of patients with ESRD to improve overall outcomes and quality of life.

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