Psychological Burden of Chronic Kidney Disease Caregivers

INTRODUCTION: Caregiver roles and responsibilities in chronic kidney disease (CKD) patients have pervasive effects on the physical, social, and emotional well-being of caregivers, yet these issues are often under-prioritized in medical management. This study assessed depression, anxiety, burden, and quality of life (QOL) in caregivers of CKD patients.

METHODS: Caregiving burden, quality of life, depression, and anxiety were assessed using the Zarit Burden Interview (ZBI), SF-36 QOL questionnaire, Beck Anxiety Inventory, and Beck Depression Inventory, respectively, among caregivers of CKD patients on maintenance hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (TX).

RESULTS: The study groups consisted of 100, 105, and 62 caregivers among PD, HD, and TX patients, respectively. The mean scores of depression, anxiety, and burden in all caregivers were 13.44 (SD 11.57), 15.77 (SD 12.49), and 13.33 (SD 9.51), respectively. More than 40% of caregivers had depression, while 68.5% reported moderate to severe anxiety. Although anxiety, depression, and burden did not differ significantly across the three groups, the physical function scores of caregivers of PD patients were significantly better than those of the other groups (P = .033). Caregivers with higher depression, anxiety, and burden scores had significantly lower scores in both physical (P < .001, P < .001, P = .022) and psychological health (all P < .001) domains of QOL. Sex and education had a strong influence on depression, anxiety, burden, and QOL.

CONCLUSION: Caregivers of CKD patients, especially females with lower education, are at increased risk of psychological burden. Early screening for mental health issues in caregivers, along with supportive interventions, should be incorporated into treatment guidelines for CKD patients.