Sex and Gender Characteristics of Adults on Hemodialysis Experiencing Depression and Depressive Symptoms: A Scoping Review
Bibliographic record
Abstract
Purpose of Review: Depression and depressive symptoms are prevalent and disproportionally high among individuals undergoing hemodialysis. Depression has emerged as the most common mental health issue within the hemodialysis community. However, the characteristics related to sex and gender among individuals receiving hemodialysis and experiencing depression and depressive symptoms are not well known. The purpose of this review is to describe the characteristics of sex and/or gender in adults receiving hemodialysis and living with depression or depressive symptoms. Sources of Information: Electronic databases included Cochrane, Embase, Medline, CINAHL, and PsycINFO, when searching for peer-reviewed literature. Methods: Systematic searches were conducted to identify peer-reviewed literature related to the characteristics of sex and gender factors among people treated with hemodialysis worldwide. Two reviewers screened 4036 titles, abstracts, and 37 full texts. Discrepancies were resolved by these same reviewers. Data from the studies that met the inclusion criteria were extracted according to the study objectives; characteristics of sex and/or gender were further analyzed by similarities and differences. Key Findings: We identified 25 peer-reviewed articles that addressed the characteristics of sex and/or gender. Of the 25 articles, 7 reported gender differences, 4 reported gender similarities, 13 reported sex differences, and 1 reported sex similarities in individuals with depression or depressive symptoms treated with hemodialysis. We found more differences than similarities in sex and gender related to depression among individuals with kidney failure undergoing hemodialysis, with notably higher rates of depressive symptoms observed in female individuals (sex) and women (gender). However, findings alert us to the possibility that due to contextual influences, male individuals may express depressive symptoms in different ways. There was substantial heterogeneity among the included papers, with nearly half of the studies conducted in Asia. In 76% of the studies, sex and gender were used interchangeably without a clear distinction; we used the term or the intention of the term used by the authors in their studies to inform our analysis. Studies further lacked any representation of gender-diverse individuals. Limitations: It is possible that additional literature on depression in relation to the characteristics of sex and gender among adults undergoing home-based hemodialysis exists; our systematic search was limited to in-center and satellite settings. Our study primarily investigated populations in Asia. It is important to note that there may have been misclassification issues with the terms "sex" and "gender."
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.004 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".