Depression Symptoms in Haemodialysis Patients Predict All-Cause Mortality but Not Kidney Transplantation: A Cause-Specific Outcome Analysis
In kidney failure patients receiving haemodialysis, depression symptoms predict mortality but are not predictive of kidney transplantation. Abstract Background Depression is common in haemodialysis (HD) patients and associated with poor outcomes. Purpose To evaluate whether depression symptoms predi...
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| Veröffentlicht in: | Annals of behavioral medicine 2018-01, Vol.52 (1), p.1-8 |
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| creator | Chilcot, Joseph Guirguis, Ayman Friedli, Karin Almond, Michael Day, Clara Da Silva-Gane, Maria Davenport, Andrew Fineberg, Naomi A Spencer, Benjamin Wellsted, David Farrington, Ken |
| description | In kidney failure patients receiving haemodialysis, depression symptoms predict mortality but are not predictive of kidney transplantation.
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 cause-specific and subdistribution hazard survival models. All models were adjusted for appropriate covariates including co-morbidity 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.
Trial Registration Number
(ISRCTN06146268). |
| doi_str_mv | 10.1007/s12160-017-9918-9 |
| format | Article |
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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 cause-specific and subdistribution hazard survival models. All models were adjusted for appropriate covariates including co-morbidity 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.
Trial Registration Number
(ISRCTN06146268).</description><identifier>ISSN: 0883-6612</identifier><identifier>ISSN: 1532-4796</identifier><identifier>EISSN: 1532-4796</identifier><identifier>DOI: 10.1007/s12160-017-9918-9</identifier><identifier>PMID: 28762106</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Aged ; Aged, 80 and over ; Cause of Death ; Comorbidity ; Depression - epidemiology ; Depression - psychology ; Depressive Disorder - epidemiology ; Female ; Follow-Up Studies ; Health psychology ; Hemodialysis ; Humans ; Kidney Failure, Chronic - epidemiology ; Kidney Failure, Chronic - psychology ; Kidney Transplantation - psychology ; Kidney Transplantation - statistics & numerical data ; Kidney transplants ; Male ; Mental depression ; Middle Aged ; Mortality ; Original ; Outcome Assessment, Health Care - statistics & numerical data ; Prognosis ; Questionnaires ; Renal Dialysis - psychology ; Renal Dialysis - statistics & numerical data ; Survival Analysis ; Transplants & implants</subject><ispartof>Annals of behavioral medicine, 2018-01, Vol.52 (1), p.1-8</ispartof><rights>The Author(s) 2017. This article is an open access publication 2017</rights><rights>The Author(s) 2017. This article is an open access publication</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-640e4c70776e7412743bb2b25c356e28448297485bab230e1fbef58dab7191293</citedby><cites>FETCH-LOGICAL-c464t-640e4c70776e7412743bb2b25c356e28448297485bab230e1fbef58dab7191293</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28762106$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chilcot, Joseph</creatorcontrib><creatorcontrib>Guirguis, Ayman</creatorcontrib><creatorcontrib>Friedli, Karin</creatorcontrib><creatorcontrib>Almond, Michael</creatorcontrib><creatorcontrib>Day, Clara</creatorcontrib><creatorcontrib>Da Silva-Gane, Maria</creatorcontrib><creatorcontrib>Davenport, Andrew</creatorcontrib><creatorcontrib>Fineberg, Naomi A</creatorcontrib><creatorcontrib>Spencer, Benjamin</creatorcontrib><creatorcontrib>Wellsted, David</creatorcontrib><creatorcontrib>Farrington, Ken</creatorcontrib><title>Depression Symptoms in Haemodialysis Patients Predict All-Cause Mortality but Not Kidney Transplantation: A Cause-Specific Outcome Analysis</title><title>Annals of behavioral medicine</title><addtitle>Ann Behav Med</addtitle><description>In kidney failure patients receiving haemodialysis, depression symptoms predict mortality but are not predictive of kidney transplantation.
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 cause-specific and subdistribution hazard survival models. All models were adjusted for appropriate covariates including co-morbidity 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.
Trial Registration Number
(ISRCTN06146268).</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cause of Death</subject><subject>Comorbidity</subject><subject>Depression - epidemiology</subject><subject>Depression - psychology</subject><subject>Depressive Disorder - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health psychology</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - epidemiology</subject><subject>Kidney Failure, Chronic - psychology</subject><subject>Kidney Transplantation - psychology</subject><subject>Kidney Transplantation - statistics & numerical data</subject><subject>Kidney transplants</subject><subject>Male</subject><subject>Mental depression</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Original</subject><subject>Outcome Assessment, Health Care - statistics & numerical data</subject><subject>Prognosis</subject><subject>Questionnaires</subject><subject>Renal Dialysis - psychology</subject><subject>Renal Dialysis - statistics & numerical data</subject><subject>Survival Analysis</subject><subject>Transplants & implants</subject><issn>0883-6612</issn><issn>1532-4796</issn><issn>1532-4796</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><recordid>eNp1ks1u1DAUhS0EokPhAdggS2xYYPBf7IRFpdHwU0ShSC1ry3HugKskDraDlGfgpfGQUhUkVrbkc47vp3MReszoC0apfpkYZ4oSyjRpGlaT5g7asEpwInWj7qINrWtBlGL8CD1I6YpSKiRT99ERr7XijKoN-vkapggp-TDii2WYchgS9iM-tTCEztt-ST7hzzZ7GHO5ROi8y3jb92Rn5wT4Y4jZ9j4vuJ0z_hQy_uC7ERZ8Ge2Ypt6OuZjD-Apv8W8HuZjA-b13-HzOLgyAt-P6zUN0b2_7BI-uz2P05e2by90pOTt_9363PSNOKpmJkhSk01RrBVoyrqVoW97yyolKAa-lrHmjZV21tuWCAtu3sK_qzraaNYw34hidrLnT3A7QuUIWbW-m6AcbFxOsN3-_jP6b-Rp-GCWUrhtZAp5dB8TwfYaUzeCTg77AQpiTYQ2vyhxNxYr06T_SqzDHApwMl7TwCF2pomKrysWQUoT9zTCMmkPVZq3alKrNoWpzoHhym-LG8afbIni-CsI8_Sfv1uqIXyWZsuQ</recordid><startdate>20180105</startdate><enddate>20180105</enddate><creator>Chilcot, Joseph</creator><creator>Guirguis, Ayman</creator><creator>Friedli, Karin</creator><creator>Almond, Michael</creator><creator>Day, Clara</creator><creator>Da Silva-Gane, Maria</creator><creator>Davenport, Andrew</creator><creator>Fineberg, Naomi A</creator><creator>Spencer, Benjamin</creator><creator>Wellsted, David</creator><creator>Farrington, Ken</creator><general>Oxford University Press</general><scope>TOX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180105</creationdate><title>Depression Symptoms in Haemodialysis Patients Predict All-Cause Mortality but Not Kidney Transplantation: A Cause-Specific Outcome Analysis</title><author>Chilcot, Joseph ; Guirguis, Ayman ; Friedli, Karin ; Almond, Michael ; Day, Clara ; Da Silva-Gane, Maria ; Davenport, Andrew ; Fineberg, Naomi A ; Spencer, Benjamin ; Wellsted, David ; Farrington, Ken</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-640e4c70776e7412743bb2b25c356e28448297485bab230e1fbef58dab7191293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cause of Death</topic><topic>Comorbidity</topic><topic>Depression - epidemiology</topic><topic>Depression - psychology</topic><topic>Depressive Disorder - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health psychology</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - epidemiology</topic><topic>Kidney Failure, Chronic - psychology</topic><topic>Kidney Transplantation - psychology</topic><topic>Kidney Transplantation - statistics & numerical data</topic><topic>Kidney transplants</topic><topic>Male</topic><topic>Mental depression</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Original</topic><topic>Outcome Assessment, Health Care - statistics & numerical data</topic><topic>Prognosis</topic><topic>Questionnaires</topic><topic>Renal Dialysis - psychology</topic><topic>Renal Dialysis - statistics & numerical data</topic><topic>Survival Analysis</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chilcot, Joseph</creatorcontrib><creatorcontrib>Guirguis, Ayman</creatorcontrib><creatorcontrib>Friedli, Karin</creatorcontrib><creatorcontrib>Almond, Michael</creatorcontrib><creatorcontrib>Day, Clara</creatorcontrib><creatorcontrib>Da Silva-Gane, Maria</creatorcontrib><creatorcontrib>Davenport, Andrew</creatorcontrib><creatorcontrib>Fineberg, Naomi A</creatorcontrib><creatorcontrib>Spencer, Benjamin</creatorcontrib><creatorcontrib>Wellsted, David</creatorcontrib><creatorcontrib>Farrington, Ken</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of behavioral medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chilcot, Joseph</au><au>Guirguis, Ayman</au><au>Friedli, Karin</au><au>Almond, Michael</au><au>Day, Clara</au><au>Da Silva-Gane, Maria</au><au>Davenport, Andrew</au><au>Fineberg, Naomi A</au><au>Spencer, Benjamin</au><au>Wellsted, David</au><au>Farrington, Ken</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Depression Symptoms in Haemodialysis Patients Predict All-Cause Mortality but Not Kidney Transplantation: A Cause-Specific Outcome Analysis</atitle><jtitle>Annals of behavioral medicine</jtitle><addtitle>Ann Behav Med</addtitle><date>2018-01-05</date><risdate>2018</risdate><volume>52</volume><issue>1</issue><spage>1</spage><epage>8</epage><pages>1-8</pages><issn>0883-6612</issn><issn>1532-4796</issn><eissn>1532-4796</eissn><abstract>In kidney failure patients receiving haemodialysis, depression symptoms predict mortality but are not predictive of kidney transplantation.
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 cause-specific and subdistribution hazard survival models. All models were adjusted for appropriate covariates including co-morbidity 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.
Trial Registration Number
(ISRCTN06146268).</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>28762106</pmid><doi>10.1007/s12160-017-9918-9</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Annals of behavioral medicine, 2018-01, Vol.52 (1), p.1-8 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Aged Aged, 80 and over Cause of Death Comorbidity Depression - epidemiology Depression - psychology Depressive Disorder - epidemiology Female Follow-Up Studies Health psychology Hemodialysis Humans Kidney Failure, Chronic - epidemiology Kidney Failure, Chronic - psychology Kidney Transplantation - psychology Kidney Transplantation - statistics & numerical data Kidney transplants Male Mental depression Middle Aged Mortality Original Outcome Assessment, Health Care - statistics & numerical data Prognosis Questionnaires Renal Dialysis - psychology Renal Dialysis - statistics & numerical data Survival Analysis Transplants & implants |
| title | Depression Symptoms in Haemodialysis Patients Predict All-Cause Mortality but Not Kidney Transplantation: A Cause-Specific Outcome Analysis |
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