Prevalence and impact of anxiety and depression in Chinese peritoneal dialysis patients: A single centre study

Chan, Koon Ming; Cheung, ST; Chan, Yiu Han; Chan, Hoi Wong; Chak, Wai Leung; Chau, Kwong Wing

doi:10.1111/nep.12970

Cited by 15 publications

(18 citation statements)

References 34 publications

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“…On the other hand, the prevalence of depression and cognitive impairment are considerably lower in our present study than previous ones. Notably, depressive symptoms are present in 27.5% patients in this study, but in over 50% of Chinese PD patients in previous reports [10,33]. Similarly, cognitive impairment is present in over 20% of patients receiving hemodialysis [9] as well as PD [10], but is less than 8% in the present study.…”

Section: Discussioncontrasting

confidence: 48%

Depression and Physical Frailty Have Additive Effect on the Nutritional Status and Clinical Outcome of Chinese Peritoneal Dialysis

Szeto¹,

Chan²,

Ng³

et al. 2018

Kidney Blood Press Res

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Background/Aims: Frailty and depression both contribute to malnutrition and adverse clinical outcome of peritoneal dialysis (PD) patients. However, their interaction is incompletely defined. Methods: We studied 178 adult Chinese PD patients. Physical frailty was assessed by a validated in-house questionnaire; depressive symptoms was screened by the Geriatric Depression Scale; nutritional status was determined by subjective global assessment (SGA) and malnutrition inflammation score (MIS). All patients were followed for up to 24 months for survival and hospitalization analysis. Results: There were 111 patients (62.4%) physically frail, amongst those 48 (43.2%) had depressive symptoms. Only 1 patient had depressive symptoms without frailty. There was an additive effect of depressive symptoms and physical frailty on nutritional status. For the groups with no frailty, frail but no depressive symptoms, and frail with depressive symptoms, serum albumin decreased in a stepwise manner (35.8 ± 5.6, 34.9 ± 4.4, and 32.9 ± 5.3 g/L, respectively, p=0.025); overall SGA score was 5.75 ± 0.61, 5.41 ± 0.59, and 5.04 ± 0.77, respectively (p< 0.0001), and MIS was 5.12 ± 2.30, 7.13 ± 3.22, and 9.48 ± 3.97, respectively (p< 0.0001). At 24 months, patient survival was 86.6%, 71.4%, and 62.5% for patients with no frailty, frail but no depressive symptoms, and frail with depressive symptoms, respective (p=0.001). The median number of hospital stay was 8.04 (inter-quartile range [IQR] 0.91 – 19.42), 14.05 (IQR 3.57 – 37.27), and 26.62 (IQR 10.65 – 61.18) days per year of follow up, respectively (p< 0.0001). Conclusion: Physical frailty and depressive symptoms are both common in Chinese PD patients, and they have additive adverse effect on the nutritional status and clinical outcome.

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Section: Discussioncontrasting

confidence: 48%

Depression and Physical Frailty Have Additive Effect on the Nutritional Status and Clinical Outcome of Chinese Peritoneal Dialysis

Szeto¹,

Chan²,

Ng³

et al. 2018

Kidney Blood Press Res

View full text Add to dashboard Cite

show abstract

“…The prevalence of depression in our study was 58.8%. The result is comparable to another local study, which reported 55% prevalence of depression among Chinese PD patients [4]. On the other hand, the worldwide prevalence of depression among dialysis population is reported to be 20-30% [27].…”

Section: Discussionsupporting

confidence: 82%

“…Depressed PD patients usually suffer from multiple physical and psychological symptoms, all of which affect their physical function, quality of life, and impede on their adherence to dialysis regimen [3]. A study in Hong Kong showed that 55% of PD patients were classified as having high emotional distress, which was an independent risk factor for the development of peritonitis [4]. Another metaanalysis also showed that the presence of depressive symptoms was a significant predictor of mortality in dialysis patients [5].…”

Section: Introductionmentioning

confidence: 99%

Depression Does Not Predict Clinical Outcome of Chinese Peritoneal Dialysis Patients After Adjusting for the Degree of Frailty

CHAN

NG²,

Chow³

et al. 2020

Preprint

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Background Depression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients. However, the interaction between depression and frailty in PD patients remains uncertain. We determined the prevalence of depression and frailty in prevalent Chinese PD patients, dissected the internal relationship between depression and frailty, and determined their relative contribution to the adverse clinical outcome in PD patients. Methods In a prospective observational study, we recruited 267 prevalent PD patients. Depression was identified by Patient Health Questionnaire (PHQ-9). Frailty was identified by a validated Frailty Score. All cases were followed for one year. Outcome measures included number and duration of hospitalization, peritonitis rate, and all-cause mortality. Results Of the 267 patients, 197 patients (73.8%) were depressed, and 157 (58.8%) were frail. There was a substantial overlap between depression and frailty. Although depression and frailty were associated the number and duration of hospitalization by univariate analysis, the association became insignificant after adjusting for confounding factors by multivariate analysis. Both depression and frailty were associated with one-year mortality by univariate analysis. One-year patient survival was 95.9%, 86.5%, 82.4% and 71.0% for patients with nil, mild, moderate and severe frailty, respectively (p = 0.001). Frailty was an independent predictor of patient survival by multivariate analysis (adjusted hazard ratio 1.424, 95% confidence interval 1.011-2.005. p = 0.043), while the prognostic effect of depression disappears after adjusting for frailty score. Conclusion Depression and frailty were common among Chinese PD patients. Frailty, but not depression, was an independent predictor of one-year mortality.

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“…Although previous studies reported that depression in patients with end stage renal disease is signi cantly associated with adverse medical outcomes, including the number of hospitalization [31] and cumulative hospital days [32], these studies were based on hemodialysis patients and may not be applicable to our patients. A local study showed that depression is signi cantly associated with mortality rate in Chinese peritoneal dialysis patients [4].…”

Section: Discussionmentioning

confidence: 99%

“…Depressed PD patients usually suffer from multiple physical and psychological symptoms, all of which affect their physical function, quality of life, and impede on their adherence to dialysis regimen [3]. A study in Hong Kong showed that 55% of PD patients were classi ed as having high emotional distress, which was an independent risk factor for the development of peritonitis [4]. Another meta-analysis also showed that the presence of depressive symptoms was a signi cant predictor of mortality in dialysis patients [5].…”

Section: Introductionmentioning

confidence: 99%

Depression Does Not Predict Clinical Outcome of Chinese Peritoneal Dialysis Patients After Adjusting for the Degree of Frailty

CHAN

NG²,

Chow³

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background Depression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients. However, the interaction between depression and frailty in PD patients remains uncertain. We determined the prevalence of depression and frailty in prevalent Chinese PD patients, dissected the internal relationship between depression and frailty, and determined their relative contribution to the adverse clinical outcome in PD patients. Methods In a prospective observational study, we recruited 267 prevalent PD patients. Depression was identified by Patient Health Questionnaire (PHQ-9). Frailty was identified by a validated Frailty Score. All cases were followed for one year. Outcome measures included number and duration of hospitalization, peritonitis rate, and all-cause mortality. Results Of the 267 patients, 197 patients (73.8%) were depressed, and 157 (58.8%) were frail. There was a substantial overlap between depression and frailty. Although depression and frailty were associated the number and duration of hospitalization by univariate analysis, the association became insignificant after adjusting for confounding factors by multivariate analysis. Both depression and frailty were associated with one-year mortality by univariate analysis. One-year patient survival was 95.9%, 86.5%, 82.4% and 71.0% for patients with nil, mild, moderate and severe frailty, respectively (p = 0.001). Frailty was an independent predictor of patient survival by multivariate analysis (adjusted hazard ratio 1.424, 95% confidence interval 1.011-2.005. p = 0.043), while the prognostic effect of depression disappears after adjusting for frailty score. Conclusion Depression and frailty were common among Chinese PD patients. Frailty, but not depression, was an independent predictor of one-year mortality.

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Prevalence and impact of anxiety and depression in Chinese peritoneal dialysis patients: A single centre study

Cited by 15 publications

References 34 publications

Depression and Physical Frailty Have Additive Effect on the Nutritional Status and Clinical Outcome of Chinese Peritoneal Dialysis

Depression and Physical Frailty Have Additive Effect on the Nutritional Status and Clinical Outcome of Chinese Peritoneal Dialysis

Depression Does Not Predict Clinical Outcome of Chinese Peritoneal Dialysis Patients After Adjusting for the Degree of Frailty

Depression Does Not Predict Clinical Outcome of Chinese Peritoneal Dialysis Patients After Adjusting for the Degree of Frailty

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