Depressive Symptoms at Kidney Transplant Evaluation and Access to the Kidney Transplant Waitlist

Overcoming the Blues: Can Managing Depressive Symptoms Improve Access to Kidney Transplantation?

“…Although older and Black transplant candidates were less likely to report depressive symptoms in the study by Chen et al. , 3 it is possible that this is because older and Black participants with these symptoms were never referred for transplant evaluation. In fact, patients with ESKD who are older and/or female are less likely to be informed of transplant options, 6 and those of minority race/ethnicity may be more likely to have psychosocial barriers limiting their access to transplant.…”

“…Those with at least minimal symptoms were 25% less likely to be transplanted or waitlisted within a year of evaluation, independent of several sociodemographic and clinical factors and despite the Center for Epidemiologic Studies—Depression results collected in the study not being considered during the clinical evaluation of the patients. 3 …”

“…To explore this, Chen et al. 3 administered the Center for Epidemiologic Studies—Depression scale to a cohort of 3879 patients being evaluated for kidney transplantation at a single US center in the course of 11 years (January 2009–March 2020). The authors found that depressive symptoms were highly prevalent (86% reporting any symptoms; minimal, mild, moderate, and severe symptoms were reported by 67%, 7%, 5%, and 7% of patients, respectively).…”

“…In conclusion, Chen et al. 3 have provided crucial data to inform the importance of treatment of depressive symptoms among kidney transplant candidates. Future studies could evaluate multiple questions of interest, including the following: the impact of receipt of a kidney transplant on depressive symptoms; the risk factors for depressive symptoms among patients who are eligible for or who have been referred for transplantation; exploration of the provider and health system factors that could serve as facilitators or barriers to interventions; and the effectiveness of interventions to mitigate depressive symptoms among patients with ESKD at all stages of the transplantation process.…”

Depression in transplantation

“…The studies reporting on the prevalence and risk factors for depression in SOT patients are summarized in Table 1. The prevalence of depression continues to vary significantly from 6.9% in lung transplant recipients [23] to 85% in kidney transplant candidates [35]. Studies continue to report on depressive symptoms rather than depressive disorders, with BDI (nine studies) and HADS (six studies) being the most used measures.…”