Depressive symptoms associate with high mortality risk and dialysis withdrawal in incident hemodialysis patients

Lacson, Eduardo; Li, Nien-Chen; Guerra-Dean, Sandie; Lazarus, Michael; Hakim, Raymond M.; Finkelstein, Fredric O.

doi:10.1093/ndt/gfr778

Cited by 49 publications

(42 citation statements)

References 25 publications

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“…We used the same derivation of depressive affect score as in our prior report (5). Briefly, the initial step was to reverse the item scores so that the higher value represents having more frequent depressive symptoms:…”

Section: Sf-36 Questions Associated With Depressive Symptomsmentioning

confidence: 99%

“…Furthermore, in addition to having greater mortality risk, depressed patients report poorer quality of life (2). Recent studies have also demonstrated an association between depressive affect, manifested by depressive symptoms, with higher mortality among patients with ESRD (3)(4)(5)(6)(7). Depressive symptoms and associated outcomes have been assessed by self-report using two questions within the Medical Outcomes Study Short Form 36 (SF-36) (4,5).…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies have also demonstrated an association between depressive affect, manifested by depressive symptoms, with higher mortality among patients with ESRD (3)(4)(5)(6)(7). Depressive symptoms and associated outcomes have been assessed by self-report using two questions within the Medical Outcomes Study Short Form 36 (SF-36) (4,5). Compared with physiciandiagnosed depression, responses indicating a frequency of occurrence of at least "a good bit of the time" for the question "Have you felt so down in the dumps nothing could cheer you up?"…”

Section: Introductionmentioning

confidence: 99%

“…had 74.2% agreement; 73.6% agreement was reported with the question "Have you felt downhearted and blue?" (4) Incident hemodialysis (HD) patients exhibit the highest rates of morbidity and mortality, and the potential role of depressive affect in exacerbating risk remains a concern (1,5). Although not necessarily diagnostic of clinical depression, elicited responses representative for depressive affect can indicate a depressive state among this patient population.…”

Section: Introductionmentioning

confidence: 99%

“…In this study, we measured the prevalence of depressive affect among an incident HD population using two questions from the SF-36 within their first 120 days of dialysis. We derived the "depression score" by combining the responses to the two survey questions associated with frequency of feeling "down in the dumps" and "downhearted and blue" (5). The mean score of these questions were used to represent depressive affect and determine the association between depressive affect and the number of hospitalization events, as well as hospital days, during a 1-year follow-up period.…”

Section: Introductionmentioning

confidence: 99%

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Depressive Affect and Hospitalization Risk in Incident Hemodialysis Patients

Lacson

Bruce

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Recent studies demonstrated an association between depressive affect and higher mortality risk in incident hemodialysis patients. This study sought to determine whether an association also exists with hospitalization risk.Design, setting, participants, & measurements All 8776 adult incident hemodialysis patients with Medical Outcomes Study Short Form 36 survey results treated in Fresenius Medical Care North America facilities in 2006 were followed for 1 year from the date of survey, and all hospitalization events lasting .24 hours were tracked. A depressive affect score was derived from responses to two Medical Outcomes Study Short Form 36 questions ("down in the dumps" and "downhearted and blue"). A high depressive affect score corresponded with an average response of "some of the time" or more frequent occurrence. Cox and Poisson models were constructed to determine associations of depressive affect scores with risk for time to first hospitalization and risk for hospitalization events, as well as total days spent in the hospital, respectively.Results Incident patients with high depressive affect score made up 41% of the cohort and had a median (interquartile range) hospitalization event rate of one (0, 3) and 4 (0, 15) total hospital days; the values for patients with low depressive affect scores were one (0, 2) event and 2 (0, 11) days, respectively. For high-scoring patients, the adjusted hazard ratio for first hospitalization was 1.12 (1.04, 1.20). When multiple hospital events were considered, the adjusted risk ratio was 1.13 (1.02, 1.25) and the corresponding risk ratio for total hospital days was 1.20 (1.07, 1.35). High depressive affect score was generally associated with lower physical and mental component scores, but these covariates were adjusted for in the models.Conclusions Depressive affect in incident hemodialysis patients was associated with higher risk of hospitalization and more hospital days. Future studies are needed to investigate the effect of therapeutic interventions to address depressive affect in this high-risk population.

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Section: Sf-36 Questions Associated With Depressive Symptomsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Depressive Affect and Hospitalization Risk in Incident Hemodialysis Patients

Lacson

Bruce

et al. 2014

Clinical Journal of the American Society of Nephrology

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Antidepressants for treating depression in adults with end-stage kidney disease treated with dialysis

Palmer

Natale²,

Ruospo

et al. 2016

Cochrane Database of Systematic Reviews

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Despite the high prevalence of depression in dialysis patients and the relative priority that patients place on effective treatments, evidence for antidepressant medication in the dialysis setting is sparse and data are generally inconclusive. The relative benefits and harms of antidepressant therapy in dialysis patients are poorly known and large randomised studies of antidepressants versus placebo are required.

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