Depressive Symptoms and Mortality in Patients After Kidney Transplantation: A Prospective Prevalent Cohort Study

Novák, Márta; Molnar, Miklos Z.; Szeifert, Lilla; Kovács, Ágnes Zsófia; Vámos, Eszter; Zoller, Rezső; Keszei, András; Mucsi, István

doi:10.1097/psy.0b013e3181dbbb7d

Cited by 106 publications

(98 citation statements)

References 65 publications

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“…5,6 Among kidney transplant (kTx) recipients, depression is associated with reduced adherence and also with increased morbidity, graft loss, and mortality. [7][8][9][10][11][12][13] Poor sleep and various sleep problems are also frequent complaints among kTx recipients.…”

Section: Introductionmentioning

confidence: 99%

Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients

Rónai

Szentkirályi

Lázár

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: Both depression and sleep complaints are very prevalent among kidney transplant (kTx) recipients. However, details of the complex relationship between sleep and depression in this population are not well documented. Thus, we investigated the association between depressive symptoms and sleep macrostructure parameters among prevalent kTx recipients. Methods: Ninety-five kTx recipients participated in the study (54 males, mean ± standard devation age 51 ± 13 years, body mass index 26 ± 4 kg/m 2 , estimated glomerular filtration rate 53 ± 19 ml/min/1.73 m 2 ). Symptoms of depression were assessed by the Center for Epidemiologic Studies -Depression Scale (CES-D). After 1-night polysomnography each recording was visually scored and sleep macrostructure was analyzed. Results: The CES-D score was significantly associated with the amount of stage 2 sleep (r = 0.20, P < .05), rapid eye movement (REM) latency (r = 0.21, P < .05) and REM percentage (r = −0.24, P < .05), but not with the amount of slow wave sleep (r = −0.12, P > .05). In multivariable linear regression models the CES-D score was independently associated with the amount of stage 2 sleep (β: 0.205; confidence interval: 0.001-0.409; P = .05) and REM latency (β: 0.234; confidence interval: 0.001-0.468; P = .05) after adjustment for potential confounders. I NTRO DUCTI O NDepression is one of the most prevalent mental health conditions in patients with chronic kidney disease (CKD) [1][2][3][4] ; furthermore, it is an important determinant of impaired quality of life. 5,6 Among kidney transplant (kTx) recipients, depression is associated with reduced adherence and also with increased morbidity, graft loss, and mortality. [7][8][9][10][11][12][13] Poor sleep and various sleep problems are also frequent complaints among kTx recipients.14,15 Earlier we reported that chronic insomnia was independently associated with the presence of depression in kTx recipients. 16 In the general population there is a strong and bidirectional relationship between depression and sleep.17 This is also reflected in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition definition of major depression (MD), 18 as sleep complaints are core symptoms of MD. Several objective sleep parameters are different in patients with MD than in healthy control patients. Patients with MD have decreased amounts of slow wave sleep (SWS) and shortened rapid eye movement (REM) latency with increased amounts of REM sleep. The exact mechanisms and factors that may link depression to poor clinical outcomes among kTx recipients are not yet well defined. In a recent review focusing on kTx and depression, 23 sleep is not mentioned. This may be due to the complete lack of polysomnography (PSG) studies that assess the association between sleep and depression in this population. The frequent co-occurrence of subjective sleep complaints and depression among kTx recipients 16 suggests that the relationship between the two conditions may be similar to the association described in the g...

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Section: Introductionmentioning

confidence: 99%

Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients

Rónai

Szentkirályi

Lázár

et al. 2017

Journal of Clinical Sleep Medicine

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“…Among kidney transplant patients, depression also appears to play an important role in terms of kidney graft survival and patient mortality. [29][30][31][32] Dobbels et al found that depression was associated with a twofold increase in risk of graft failure, return to dialysis, and death with a functioning graft. 32 Novak et al found that depressed patients were at greater risk of death over the study follow-up compared to nondepressed clients.…”

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confidence: 99%

“…32 Novak et al found that depressed patients were at greater risk of death over the study follow-up compared to nondepressed clients. 29 The association between negative mood states and poor clinical outcomes in kidney transplant patients might be explained by several factors, for example, with nonadherence to treatment regimens. [33][34][35] Furthermore, depression in kidney transplant patients is associated with unhealthy behaviors including sedentary lifestyles, lower activity levels, and higher alcohol use, which may be associated with transplant-related outcomes.…”

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Psychological rejection of the transplanted organ and graft dysfunction in kidney transplant patients

Látos¹,

Lázár²,

Horváth³

et al. 2016

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“…A prospective cohort study of 840 transplanted patients over 5-year period found a higher mortality rate in patients with depression as compared to patients without (21% vs 13%; p = 0.004). 47 Psychiatric symptoms could also affect the likelihood of patients who are put on the kidney transplant waiting list. Bayat et al found that the presence of a psychiatric disorder was a strong, independent factor in determining access to the transplant waitlist.…”

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Anxiety and depression in patients with end-stage renal disease: impact and management challenges – a narrative review

Goh¹,

Griva²

2018

IJNRD

160

125

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Psychiatric disorders commonly co-exist with the diagnosis of chronic kidney disease (CKD). Research on depression and CKD has increased to a great extent. Multiple studies have demonstrated that depression is more prevalent in CKD and that end-stage renal disease is a robust risk factor for adverse outcomes such as hospitalization and mortality, yet these are often underdiagnosed or untreated. This review provides a selective overview on the prevalence rates of depression and anxiety in patients with CKD and across renal replacement therapies, the factors most consistently associated with symptoms of distress and their clinical implications. Finally, treatment and management strategies from relevant literature are appraised and discussed.

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Depressive Symptoms and Mortality in Patients After Kidney Transplantation: A Prospective Prevalent Cohort Study

Abstract: Depressive symptoms are an independent predictor of mortality in kidney transplanted patients.

Cited by 106 publications

References 65 publications

Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients

Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients

Psychological rejection of the transplanted organ and graft dysfunction in kidney transplant patients

Anxiety and depression in patients with end-stage renal disease: impact and management challenges – a narrative review

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Depressive Symptoms and Mortality in Patients After Kidney Transplantation: A Prospective Prevalent Cohort Study

Abstract: Depressive symptoms are an independent predictor of mortality in kidney transplanted patients.

Cited by 106 publications

References 65 publications

Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients

Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients

Psychological rejection of the transplanted organ and graft dysfunction in kidney transplant patients

Anxiety and depression in patients with end-stage renal disease: impact and management challenges &ndash; a narrative review

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Anxiety and depression in patients with end-stage renal disease: impact and management challenges – a narrative review