BACKGROUND: Depression is not uncommon among patients with end-stage renal disease (ESRD) being treated by hemodialysis. We investigated whether risk of mortality and rate of hospitalization may be predicted from physician-diagnosed depression and patients' self-reports of depressive symptoms. METHODS: Data were analyzed from the Dialysis Outcomes and Practice Patterns Study (DOPPS) for randomly selected ESRD patients being treated by hemodialysis in the United States (142 facilities, 2855 patients) and five European countries (101 facilities, 2401 patients). The diagnosis of depression during the past year was abstracted from the medical records. In addition, the patients were asked to indicate how much of their time over the previous four weeks they had felt (1) "so down in the dumps that nothing could cheer you up" and (2) "downhearted and blue." A response of "a good bit,""most," or "all" of the time were classified as depressed. RESULTS: The prevalence of depression was nearly 20%. The relative risks of mortality and hospitalization among depressed (vs. non-depressed), adjusted for time on dialysis, age, race, socioeconomic status, comorbid indicators and country were, respectively: 1.23 and 1.11 for physician-diagnosed depression, 1.48 and 1.15 for the "so down in the dumps" question, and 1.35 and 1.11 for the "downhearted and blue" question (P < 0.05 for all six relative risks). These associations were not significantly different between US and European patients. CONCLUSIONS: Self-reported depression by two simple questions was associated with increased risks of mortality and hospitalization for hemodialysis patients. Future research needs to assess whether early identification and treatment of depression may help to improve quality of life and survival in hemodialysis patients.
BACKGROUND:Depression is not uncommon among patients with end-stage renal disease (ESRD) being treated by hemodialysis. We investigated whether risk of mortality and rate of hospitalization may be predicted from physician-diagnosed depression and patients' self-reports of depressive symptoms. METHODS: Data were analyzed from the Dialysis Outcomes and Practice Patterns Study (DOPPS) for randomly selected ESRDpatients being treated by hemodialysis in the United States (142 facilities, 2855 patients) and five European countries (101 facilities, 2401 patients). The diagnosis of depression during the past year was abstracted from the medical records. In addition, the patients were asked to indicate how much of their time over the previous four weeks they had felt (1) "so down in the dumps that nothing could cheer you up" and (2) "downhearted and blue." A response of "a good bit,""most," or "all" of the time were classified as depressed. RESULTS: The prevalence of depression was nearly 20%. The relative risks of mortality and hospitalization among depressed (vs. non-depressed), adjusted for time on dialysis, age, race, socioeconomic status, comorbid indicators and country were, respectively: 1.23 and 1.11 for physician-diagnosed depression, 1.48 and 1.15 for the "so down in the dumps" question, and 1.35 and 1.11 for the "downhearted and blue" question (P < 0.05 for all six relative risks). These associations were not significantly different between US and European patients. CONCLUSIONS: Self-reported depression by two simple questions was associated with increased risks of mortality and hospitalization for hemodialysis patients. Future research needs to assess whether early identification and treatment of depression may help to improve quality of life and survival in hemodialysis patients.
Authors: Michael J Fischer; Paul L Kimmel; Tom Greene; Jennifer J Gassman; Xuelei Wang; Deborah H Brooks; Jeanne Charleston; Donna Dowie; Denyse Thornley-Brown; Lisa A Cooper; Marino A Bruce; John W Kusek; Keith C Norris; James P Lash Journal: Kidney Int Date: 2011-06-01 Impact factor: 10.612
Authors: Matthew P Buman; Eric B Hekler; William L Haskell; Leslie Pruitt; Terry L Conway; Kelli L Cain; James F Sallis; Brian E Saelens; Lawrence D Frank; Abby C King Journal: Am J Epidemiol Date: 2010-09-15 Impact factor: 4.897
Authors: Brian T Agganis; Daniel E Weiner; Lena M Giang; Tammy Scott; Hocine Tighiouart; John L Griffith; Mark J Sarnak Journal: Am J Kidney Dis Date: 2010-07-29 Impact factor: 8.860
Authors: Mehdi Rambod; Rachelle Bross; Jennifer Zitterkoph; Deborah Benner; Juhi Pithia; Sara Colman; Csaba P Kovesdy; Joel D Kopple; Kamyar Kalantar-Zadeh Journal: Am J Kidney Dis Date: 2008-12-13 Impact factor: 8.860
Authors: Hugh C Rayner; Lindsay Zepel; Douglas S Fuller; Hal Morgenstern; Angelo Karaboyas; Bruce F Culleton; Donna L Mapes; Antonio A Lopes; Brenda W Gillespie; Takeshi Hasegawa; Rajiv Saran; Francesca Tentori; Manfred Hecking; Ronald L Pisoni; Bruce M Robinson Journal: Am J Kidney Dis Date: 2014-02-14 Impact factor: 8.860
Authors: Fredric O Finkelstein; Kelli L Arsenault; Ana Taveras; Kwabena Awuah; Susan H Finkelstein Journal: Nat Rev Nephrol Date: 2012-10-23 Impact factor: 28.314