Background: Research suggests that patients with end stage renal disease undergoing hemodialysis have a higher\nrate of depression and dietary non adherence leading to hospitalization and mortality. The purpose of this review\nwas to synthesize the quantitative evidence on the relationship between depressive symptoms and dietary non\nadherence among end stage renal disease (ESRD) patients receiving hemodialysis.\nMethods: A systematic review was undertaken. Three electronic databases were searched including PubMed,\nCINHAL and Web of Science. Only quantitative studies published between 2001 and 2016 were included in the\nreview.\nResult: A total of 141 publications were reviewed during the search process and 28 articles that fulfilled the\ninclusion criteria were included in the review. Eleven studies (39.3%) reported on the prevalence of depressive\nsymptoms or depression and its effect on patient outcomes. Ten studies (35.7%) focused on dietary adherence/non\nadherence in patients with ESRD and the remaining seven (25%) articles were descriptive studies on the\nrelationship between depressive symptoms and dietary non adherence in patients with ESRD receiving\nhemodialysis. The prevalence of depressive symptoms and dietary non adherence ranged as 6-83.49% and from\n41.1-98.3% respectively. Decreased quality of life & increased morbidity and mortality were positively associated\nwith depressive symptoms. Other factors including urea, hemoglobin, creatinine and serum albumin had also\nassociation with depressive symptoms. Regarding dietary non adherence, age, social support, educational status,\nbehavioral control and positive attitudes are important factors in ESRD patients receiving hemodialysis. Having\ndepressive symptoms is more likely to increase dietary non adherence.\nConclusion: Depressive symptoms and dietary non adherence were highly prevalent in patients with end stage\nrenal disease receiving hemodialysis therapy. Nearly all of the articles that examined the relationship between\ndepressive symptoms and dietary non adherence found a significant association. Future research using\nexperimental or longitudinal design and gold standard measures with established cut-points is needed to further\nexplain the relationship.
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