Prevalence of Depression and Its Associated Factors among Hemodialysis Patients in Hodeida City, Yemen [Response to Letter]

This article responds to:

Prevalence of Depression and Its Associated Factors Among Hemodialysis Patients in Hodeida City, Yemen [Letter]

Dear editor

We sincerely appreciate your interest in our study, “Prevalence of depression and its associated factors among hemodialysis patients in Hodeida city, Yemen”. We would like to express our gratitude to all the authors for recognizing the study’s importance in shedding light on an often overlooked population amid war-related crises. We also acknowledge the positive feedback on employing the OpenEpi website formula for sample size calculation and conducting a comparative analysis with international studies.¹

We acknowledge the insightful feedback from Wang et al,² particularly regarding the suggestion to use G*Power version 3.1.9.7 software for sample size calculation. We will explore this alternative for future research. Regarding the areas that need correction, the authors rightly pointed out two corrections. The female count in Table 2 needs correction to 51 instead of 52, and the odds ratio and confidence interval values on page 693 should be as follows: (odds ratio (OR) = 3.352; 95% confidence interval (CI) = 1.484–7.570; p = 0.004).

Regarding the limited variables included in the multivariate logistic regression, we recognize the potential benefits and risks associated with incorporating variables with P-values less than 0.1 or 0.2 from univariate analysis.³ In our study, we excluded the marital status variable due to one cell containing zero, which could impact interpretation.⁴ We also considered other factors based on the significant association in the chi-square test, as outlined in the limitations of the published study.

In the recommendation for future research is well-taken. We acknowledge the need for a large-scale, multicenter study to provide more robust conclusions. The suggestions for further investigation, including qualitative research on the subjective experiences of hemodialysis patients with depressive symptoms during the ongoing war in Yemen, establishing a control group, and utilizing structural equation models or mediating effects models, are valuable and will be considered in our future research endeavors.

In summary, we appreciate both the acknowledgment of the study’s strengths and the constructive feedback for improvement provided in the letter to the editor.

Disclosure

The authors declare that they have no conflicts of interest in this communication.