Dialysis and depression: evaluating treatment options for
depression in patients undergoing hemodialysis

Dialysis and quality of life

Today, more than 400,000 patients in the United States treat their kidney failure, or end-stage renal disease (ESRD), with hemodialysis. These patients face many challenges, resulting in a significantly lower quality of life. Most attend four-hour dialysis sessions three times a week, follow a strict, low-salt diet, take an average of 17 pills every day, have other medical conditions, and frequently transition between receiving care in the dialysis facility and the hospital.

Depression: an additional hurdle

With such a high burden of both disease and its treatment, many dialysis patients also develop moderate to severe symptoms of depression. Dialysis patients with depression are more likely to have complications, like heart problems, and be hospitalized, and they are more likely to stop dialysis.

Although depression is very common in dialysis patients, it is often undiagnosed and thus goes untreated. It is important to recognize depressive symptoms and identify effective treatments of depression that will improve health outcomes in dialysis patients.

In this trial: evaluating treatments for depression

The ASCEND trial is the first randomized, controlled clinical trial among adult hemodialysis patients that will evaluate two ways to treat depression with the aim that it's results would help clinicians make more informed treatment decisions in the future, as well as inform regulators, policy makers, and dialysis organizations on how to restructure the delivery of healthcare to provide meaningful improvement in health of dialysis patients.

It will compare the effectiveness of two different treatment methods — Cognitive Behavioral Therapy and drug therapy — in patients at clinical sites in Seattle, Dallas and Albuquerque.