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Depressive affect in incident hemodialysis patients
Kathryn A McDougall1, John W Larkin2, Rebecca L Wingard1
1Clinical Innovation Initiatives, Fresenius Medical Care North America, Waltham, MA 02451.
Clinical Kidney Journal
|February 10, 2018
Summary
Depressive affect is common in new hemodialysis patients, leading to more hospitalizations. Early screening and intervention are crucial for managing depression in this population.
Area of Science:
- Nephrology
- Psychiatry
- Public Health
Background:
- The prevalence and impact of depressive affect in patients initiating hemodialysis (HD) are not well-established.
- Understanding these factors is critical for improving patient outcomes in this vulnerable population.
Purpose of the Study:
- To determine the prevalence of depressive affect in incident HD patients.
- To identify associated risk factors and hospitalization rates in this cohort.
Main Methods:
- A prospective study involving 543 incident HD patients screened using the Patient Health Questionnaire 2 (PHQ2).
- Depressive affect was assessed at 1-30 and 121-150 days post-initiation of HD.
- Risk factors and hospitalization rates were analyzed based on depressive affect status.
Main Results:
- Depressive affect prevalence was 20.2% at 1-30 days and 18.5% at 121-150 days.
- Patients with depressive affect experienced significantly higher hospitalization rates (1.5 more admissions and 10.5 more hospital days per patient-year).
- Female patients showed a higher risk of depressive affect within the first 30 days.
Conclusions:
- Depressive affect is prevalent throughout the initial period of hemodialysis treatment.
- Increased hospital admissions and days are associated with depressive affect in incident HD patients.
- These findings highlight the need for systematic screening and management of depression in HD patients.
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