King's College London

Research portal

Depression symptoms in haemodialysis patients predict all-cause mortality but not kidney transplantation: a cause-specific outcome analysis

Research output: Contribution to journalArticle

Joseph Chilcot, Ayman Guirguis, Karin Friedli, Michael Almond, Clara Day, Maria Da Silva-Gane, Andrew Davenport, Naomi A. Fineberg, Benjamin Spencer, David Wellsted, Ken Farrington

Original languageEnglish
Pages (from-to)1-8
JournalAnnals of behavioral medicine : a publication of the Society of Behavioral Medicine
Volume52
Issue number1
Early online date31 Jul 2017
DOIs
Publication statusPublished - 5 Jan 2018

Documents

King's Authors

Abstract

Background
Depression is common in haemodialysis (HD) patients and associated with poor outcomes.
Purpose
To evaluate whether depression symptoms predict survival and transplantation in a large sample of haemodialysis patients using cause-specific survival models.
Methods
Survival data was collected between April 2013 and November 2015, as part of the screening phase of a multicentre randomised placebo-controlled trial of sertraline in HD patients. Depression was measured using the Beck Depression Inventory-II (BDI-II) and the Patient Health
Questionnaire-9 (PHQ-9). Demographic and clinical data were collected via a self-report questionnaire and medical records. Competing risk survival analysis involved causespecific and subdistribution hazard survival models. All models were adjusted for appropriate covariates including comorbidity and C-reactive protein (CRP) in a subanalysis.
Results
Of 707 cases available for analysis, there were 148 deaths. The mean survival time was 787.5 days. Cumulative survival at 12 months was 88.5%. During the study follow-up period, there were 92 transplants. The cumulative transplant event rate at 12 months was 7.8%. In separate adjusted models, depression symptoms predicted mortality (BDI-II
HR = 1.03 95% CI 1.01, 1.04; PHQ-9 HR = 1.04 95% CI 1.01, 1.06). With respect to screening cut-off scores, a PHQ-9 ≥ 10 was associated with mortality (HR = 1.51 95% CI 1.01, 2.19) but not a BDI-II ≥ 16. Depression symptoms were not associated with time to transplantation in either cause-specific or subdistribution model.
Conclusions
Consistent with past findings in HD patients, depression symptoms predicted survival but were not associated with kidney transplantation. Suitable treatments for depression need further evaluation, and their impact upon quality of life and clinical outcomes determined.

Download statistics

No data available

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454