Social support and subsequent mortality among patients with end-stage renal disease

The association between social support in newly entered dialysis patients and their subsequent risk of mortality was investigated. Two hundred forty-nine dialysis patients were enrolled from dialysis facilities in two southeastern states. A score was calculated for the amount of social support a patient reported giving and receiving from spouse, family, friends, nurses, physicians, staff, and fellow patients. Patients were monitored for 12 months after enrollment into the cohort: 43 (17.6%) died. Mean (SD) scores for giving support to the family were higher among survivors, 3.59 (0.92), than among those who died, 3.17 (1.32) (P = 0.022). Mean scores for giving support to friends were also higher among survivors, 3.38 (1.13), than among nonsurvivors, 2.94 (1.33) (P = 0.044). After other factors associated with increased risk of dying, including age, sex, race, diabetic renal disease, angina pectoris, and functional status, were controlled for, individuals in the lowest quartile of giving social support to friends continued to have a greater risk of dying, with adjusted relative risk (95% confidence interval) = 2.02 (1.01, 4.07). In contrast, there were no differences in risk of death found for differing levels of receiving social support. It was concluded that social support is an independent risk factor for mortality among new dialysis patients.