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Major Depression and Long-Term Outcomes of Acute Kidney Injury

Rasheed A Balogun1, Bolanle A Omotoso, Wenjun Xin

  • 1Division of Nephrology, University of Virginia, Charlottesville, Va., USA.

Nephron
|September 23, 2016
PubMed

Insights

Patients with acute kidney injury (AKI) and depression face higher long-term risks for major adverse cardiovascular events (MACE) and death. This study highlights depression as a significant factor impacting outcomes after AKI hospitalization.

Area of Science:

  • Nephrology
  • Cardiology
  • Psychiatry

Background:

  • Depression is linked to poor outcomes in chronic kidney disease.
  • The prognostic impact of depression in acute kidney injury (AKI) is not well understood.
  • This study investigates the long-term effects of depression on patients hospitalized with AKI.

Purpose of the Study:

  • To determine the prognostic implication of a depression diagnosis on renal recovery after AKI.
  • To assess the risk of major adverse cardiovascular events (MACE) in AKI patients with pre-existing depression.
  • To evaluate the association between depression and all-cause mortality following AKI hospitalization.

Main Methods:

  • A cohort of 11,425 adult patients admitted to the University of Virginia Medical Center between 2002-2012 with AKI and surviving beyond 90 days was analyzed.
  • Patients were categorized into two groups: those with a pre-existing diagnosis of major depression and those without.
  • Multivariable Cox proportional hazards regression was used to examine the association between major depression and long-term outcomes, adjusting for risk factors.

Main Results:

  • 2,519 (22%) of AKI patients had a diagnosis of major depression, more common in younger females, African Americans, and those with comorbidities like CHF, CVD, and diabetes.
  • Patients with major depression showed a crude hazard ratio of 1.245 for MACE (95% CI 1.150-1.348) and 1.186 for all-cause mortality (95% CI 1.091-1.290).
  • This indicates a 24% increased long-term risk for MACE and an 18% increased risk for all-cause mortality in AKI patients with major depression.

Conclusions:

  • Pre-existing major depression is associated with significantly increased long-term risks of MACE and all-cause mortality in patients hospitalized with AKI.
  • These findings underscore the importance of considering mental health in the management of AKI patients.
  • Further research may explore interventions to mitigate these adverse outcomes.
Abstract

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