Pooled Prevalence of Depression Among Chronic Kidney Disease Patients in Thailand: A Systematic Review and Meta-analysis

Background: Depression is common among patients with chronic kidney disease (CKD) receiving renal replacement therapy (RRT) and is associated with poorer outcomes. This study aimed to estimate the pooled prevalence of depression among Thai CKD patients receiving RRT and examine variation by assessment instrument and dialysis modality. Method: Following PRISMA 2020 guidelines, we systematically searched five databases (ThaiJo, ThaiLIS, PubMed, Scopus, and ScienceDirect) from January 1, 2015 to December 31, 2025, and assessed methodological quality using Joanna Briggs Institute (JBI) criteria. The pooled prevalence was estimated using a random-effects model with REML estimation and Freeman–Tukey double arcsine transformation. Results: Eleven high-quality studies involving 1,099 participants were included. The pooled prevalence of depression was 25.90% (95% CI: 18.00%–34.60%; I² = 89.76%). Prevalence was higher with the Beck Depression Inventory-II (36.90%, 95% CI: 31.50%–42.50%) than with the Patient Health Questionnaire-9 (18.90%, 95% CI: 9.30%–30.80%), with significant subgroup differences (p = 0.03). Continuous ambulatory peritoneal dialysis showed a higher pooled prevalence (27.90%, 95% CI: 13.10%–45.60%) than hemodialysis (18.90%, 95% CI: 11.90%–28.90%), with borderline subgroup differences (p = 0.05). Conclusion: These findings provide the first pooled estimate of depression prevalence among Thai CKD patients receiving RRT and support routine depression screening, mental health integration, and targeted interventions in nephrological settings.