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A cohort study to assess the impact of depression on patients with kidney disease
Paulo Roberto Zimmermann1, Suzi Alves Camey, Jair de Jesus Mari
1Pontifícia Universidade Católica do Rio Grande do Sul. przimmer@terra.com.br
Insights
Depression impacts kidney disease patients' quality of life but not mortality. Kidney disease patients who received a transplant had lower mortality rates. Depression significantly predicted lower quality of life.
Area of Science:
- Nephrology
- Psychiatry
- Public Health
Background:
- Depression is a common comorbidity in patients with kidney disease.
- The impact of depression on mortality and quality of life in this population requires further investigation.
Purpose of the Study:
- To assess the effect of depression on mortality in kidney disease patients.
- To evaluate the association between depression and quality of life in kidney disease patients.
Main Methods:
- A cohort of 125 kidney disease patients undergoing renal replacement therapy were followed for a mean of 77.6 months.
- Depression was assessed using the Beck Depression Inventory (BDI).
- Quality of life was measured using the Medical Outcome Study Short Form General Health Survey (SF-36).
Main Results:
- Initial analysis indicated mortality was associated with age, treatment modality (CAPD/HD), and depression.
- Multiple regression analysis revealed transplantation, gender, and age were associated with lower mortality.
- Depression levels at follow-up were strongly associated with quality of life.
Conclusions:
- Depression was not a significant predictor of mortality in kidney disease patients when controlling for demographic and treatment factors.
- Kidney transplantation emerged as the primary factor linked to reduced mortality.
- Depression significantly predicted poorer quality of life, with more depressive symptoms correlating with lower SF-36 scores across most domains.
Aims:
This study assessed the impact of depression on mortality and quality of life of patients with kidney disease.
Material:
This study was conducted at Hospital São Lucas of Pontificia Universidade Católica of Rio Grande do Sul, Porto Alegre, Brazil, with a cohort of 125 patients seen from 1996 to 2004. (mean follow-up = 77.6 months). Patients undergoing renal replacement therapy were asked to fill in the Beck Depression Inventory (BDI). At the completion of follow-up, 72 patients were alive, and 56 answered the BDI and the Medical Outcome Study Short Form General Health Survey (SF-36) to assess quality of life. Main outcome measures were mortality and quality of life.
Results:
Initial analysis showed that mortality was associated with age, treatment modality--continuous ambulatory peritoneal dialysis (CAPD) or hemodialysis (hd)--and depression. When controlling for age, gender, depression, and treatment modality in a multiple regression analysis, transplantation (tx), gender and age was associated with lower mortality. However, levels of depression at the end of follow-up were strongly associated with quality of life.
Conclusions:
Depression was not associated with mortality of patients with kidney disease when controlling for gender, age, and treatment modality. Transplantation was the main factor associated with lower mortality. Depression was, however, a strong predictor of quality of life. Number of depressive symptoms was directly associated with lower quality of life in most of the items of the SF-36.
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