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Is depression a risk factor for mortality in chronic hemodialysis patients?

Edgar C Diefenthaeler1, Mário Bernardes Wagner, Carlos Eduardo Poli-de-Figueiredo

  • 1Programa de Pós-Graduação em Medicina e Ciências da Saúde, Serviço de Nefrologia, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil. edgarcd@terra.com.br

Revista Brasileira De Psiquiatria (Sao Paulo, Brazil : 1999)
|July 2, 2008
PubMed

Insights

Depressive symptoms in chronic hemodialysis patients are linked to higher mortality. Further research is needed to confirm if depression is an independent risk factor for these patients.

Area of Science:

  • Nephrology
  • Psychiatry
  • Clinical Epidemiology

Background:

  • Chronic hemodialysis patients face significant mortality risks.
  • Depressive symptomatology is common in this population but its impact on mortality requires further clarification.

Purpose of the Study:

  • To investigate the association between depressive symptoms and mortality in patients undergoing chronic hemodialysis.
  • To determine if depressive symptomatology is an independent risk factor for mortality in this cohort.

Main Methods:

  • A cohort of 40 hemodialysis patients was followed for a median of 10.5 months.
  • The Beck Depression Inventory (BDI) classified patients as depressed (BDI score > 14) or not.
  • Kaplan-Meier survival analysis and Cox proportional hazards models were used to assess mortality risk.

Main Results:

  • After 24 months, survival rates were 39% for depressed patients versus 95% for non-depressed patients (p=0.029).
  • Depressive symptomatology showed a trend towards association with mortality (HR=6.5, p=0.085) in initial analysis.
  • This association lost statistical significance when kidney transplantation rates were considered (HR=4.5, p=0.17).

Conclusions:

  • Depressive symptoms may be associated with increased mortality in chronic hemodialysis patients.
  • The role of depressive symptoms as an independent risk factor requires further investigation, especially considering confounding factors like kidney transplantation.
Abstract

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