7th Call - Dr. Patrick Adjei
Project Title: Psychological Wellbeing and Quality of Life in Chronic Kidney Disease Patients in Accra, Ghana
Principal Investigator: Dr. Patrick Adjei (Department of Medicine and Therapeutics UGMS)
Email Address: padjei@ug.edu.gh
Award Amount: GHC 24,991.00
Project Status: On-going
Summary:
Chronic kidney disease (CKD) is defined as kidney damage as evidenced by proteinuria or haematuria or an estimated Glomerular Filtration Rate (GFR) of less than 60 ml/min/1.73m2 that has persisted for at least three months. CKD is classified into five stages with Stage Five known as End-Stage Renal Disease (ESRD). ESRD is the loss of renal function requiring treatment such as chronic dialysis or transplantation. The disease, treatment and associated demands have a significant impact on the patient’s physical and emotional wellbeing and interfere with the patient’s social roles. Patients with CKD who are being prepared for, or receiving renal replacement therapy often experience difficulties in participating in various domains of life such as paid work, sports and other social and leisure activities. Poor quality of life, depression and other psychological problems tend to worsen their prognosis.
Currently, there are no figures from Ghana on the prevalence of CKD. Recent data from Korle-Bu Teaching Hospital showed that 15% of all medical admissions have kidney disease. In addition 10% of all deaths on the medical wards are due to chronic kidney disease. Most patients with CKD are aged between 20 and 50 years, representing the economically active group of our society.
Considerable progress has been made in the treatment and nursing intervention of CKD, however, health-related quality of life (QoL) continues to be a significant problem for patients receiving hemodialysis 9. This has been important especially for chronic conditions such as CKD. The combination of a decrease in energy, the unavoidable emergence of socioeconomic problems, and emotional reactions associated with haemodialysis compounds the stress facing the patient.
Depression remains under-recognized and undertreated, particularly among ESRD patients. A cross sectional study conducted in 2011 to determine the prevalence of depression and to determine the quality of life among ESRD patients on dialysis in Korle-Bu Teaching Hospital showed a prevalence of depression of 44.3% among these patients and the quality of life among these patients was poor but interestingly, this had no significant bearing on socio-economic status of these patients. Nevertheless this research involved only ESRD patients on haemodialysis and therefore the findings may not represent the true prevalence of depression among CKD patients and in addition cognitive status was not assessed.
This 3-year study therefore seeks to establish the prevalence of depression and assess quality of life among non-dialysis ESRD patients and ESRD individuals on haemodialysis. Further, this study seeks to examine the nature, pattern extent and severity of cognitive deficits among these individuals. This study will determine the association between quality of life, psychosocial profile and cognitive functioning in this cohort of patients.
It is envisaged that the results will expand the understanding of the psychological impact of end stage renal disease in the Ghanaian population. High rate of depression and poor quality of life are expected among these patients in Ghana compared to developed countries due to added factors such as poor socio-economic situation in our part of the world. This will foster collaborations between psychology and psychiatric departments, and the Renal unit with the hope that a more holistic treatment and management of ESRD individuals will advance the understanding ESRD in Ghana.