The Effect of Depression in Chronic Hemodialysis Patients on Inpatient Hospitalization Outcomes

Abstract

Background/Aims: Depression is common in patients with end-stage renal disease (ESRD) on hemodialysis (HD). Although, depression is associated with mortality, the effect of depression on in-hospital outcomes has not been studied as yet. Methods: We analyzed the National Inpatient Sample for trends and outcomes of hospitalizations with depression in patients with ESRD. Results: The proportion of ESRD hospitalizations with depression doubled from 2005 to 2013 (5.01-11.78%). Hospitalized patients on HD with depression were younger (60.47 vs. 62.70 years, p < 0.0001), female (56.93 vs. 47.81%, p < 0.0001), white (44.92 vs. 34.01%, p < 0.0001), and had higher proportion of comorbidities. However, there was a statistically significant lower risk of mortality in HD patients within the top 5 reasons for admissions. Conclusion: There were significant differences in demographics and comorbidities for hospitalized HD patients with depression. Depression was associated with an increased rate of adverse effects in discharged patients, and decreased in-hospital mortality.

Trends and Racial Disparities of Palliative Care Use among Hospitalized Patients with ESKD on Dialysis

“…We identified the patient population using ICD-9-CM codes of 585.6 (CKD5 requiring chronic dialysis) and diagnostic or procedure codes related to dialysis (listed in Supplemental Table 1). 27 The exclusion criteria included elective admission, missing data on race/ethnicity (approximately 6% of all hospitalizations in NIS), and diagnosis of AKI on admission or status post-kidney transplant (diagnoses codes are listed in Supplemental Table 1). 25 The primary outcome was the temporal trend of palliative care referral overall and by race/ethnicity.…”

“…These values are derived from zip code demographic data obtained from Claritas. The quartiles are identified by values of 1-4, indicating the poorest to wealthiest populations 27. b The hospital's teaching status was obtained from the American Hospital Association (AHA) Annual Survey of Hospitals.…”

“…Nonmetropolitan hospitals were not split according to teaching status because rural teaching hospitals were rare. The metropolitan categorization is a simplified adaptation of the 2003 version of the Urban Influence Codes and includes both large and small metropolitan areas 27. c Bed size categories are based on hospital beds, and are specific to the hospital's location and teaching status.…”

Intermittent versus daily dosing of meropenem in haemodialysis patients – A retrospective observational exploratory study

“…Patients on haemodialysis tend towards developing depression and poor quality of life (16), which have been found to correlate with longer length of stay in hospital (17,18). An approach which reduces hospital stay and allows the patient to resume normal activities is likely to be welcomed.…”

Exploring demands of hemodialysis patients in Taiwan: A two-step cluster analysis

“…Depression may induce immune deficiency, loss of appetite, and malnutrition, rendering patients unable to cope with their prescribed therapy; depression can also provoke suicide, thus indirectly raising the mortality rate [10]. Gender, age, and comorbidity have been recognized as critical factors leading to depression [11]; lack of social support and a lengthy treatment regimen may also result in depression [12,13].…”