Depression and Cognitive Function in Maintenance Hemodialysis Patients

Agganis, Brian T.; Weiner, Daniel E.; Giang, Lena M.; Scott, Tammy; Tighiouart, Hocine; Griffith, John L.; Sarnak, Mark J.

doi:10.1053/j.ajkd.2010.04.018

Cited by 121 publications

(103 citation statements)

References 52 publications

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“…Similar high levels of psychiatric morbidity in critically ill patients have been found by other authors [15]. Among patients receiving haemodialysis for end-stage renal disease, symptoms of anxiety and depression are common, with 45.7% of subjects meeting criteria for an anxiety disorder [16] and 23.7% with significant depressive symptoms [17]. Symptoms consistent with post-traumatic stress are also common in this patient [11] assessed QoL in survivors of critical illness with AKI across ten centres in Finland, using the EuroQol-5D (EQ-5D) questionnaire.…”

Section: Discussionsupporting

confidence: 80%

Psychological outcomes in critically ill patients receiving renal replacement therapy: a matched‐pairs analysis

et al. 2014

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SummaryWe conducted a single-centre observational study over five years to assess the impact of renal replacement therapy on the psychological health of survivors of critical illness. We hypothesised that the added burden of renal replacement would increase the prevalence and severity of anxiety, depression and stress reactions in these patients, compared with matched pairs (matched for age, sex and APACHE II score) who did not receive renal replacement. Participants completed postal questionnaires. A total of 342 patients with acute kidney injury received renal replacement. One hundred and seventy-nine (52.3%) survived to hospital discharge, and 161 (47.1%) were alive at 90 days. Seventy-seven (47.8% of survivors) completed questionnaires. We found 77 matches for the Hospital Anxiety and Depression Scale analysis and 72 for the Impact of Events Scale analysis. Clinically relevant symptoms of psychiatric morbidity were common, with anxiety and depression affecting 49 (63.6%) patients and stress reactions affecting 24 (33.3%) patients. Mean scores (95% CI) were 11.4 (9.6-13.2) and 20.1 (15.7-24.6), respectively. On multivariate analysis, we found no significant differences between renal replacement patients and controls, in either the frequency or severity of these symptoms.

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Section: Discussionsupporting

confidence: 80%

Psychological outcomes in critically ill patients receiving renal replacement therapy: a matched‐pairs analysis

et al. 2014

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“…Depressive affect can directly influence poor adherence to diet and fluid regimens (16). Furthermore, chemical brain alterations in depressed patients may affect cognitive dysfunction (which may manifest as poor adherence) (17), and cognitive dysfunction has been associated with depressive affect in HD patients (18). Poor adherence may also extend to missed HD treatments, which has been associated with greater risk for hospitalization from not just cardiovascular causes but all-causes as well (19,20).…”

Section: Discussionmentioning

confidence: 99%

Depressive Affect and Hospitalization Risk in Incident Hemodialysis Patients

Lacson

Bruce

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Recent studies demonstrated an association between depressive affect and higher mortality risk in incident hemodialysis patients. This study sought to determine whether an association also exists with hospitalization risk.Design, setting, participants, & measurements All 8776 adult incident hemodialysis patients with Medical Outcomes Study Short Form 36 survey results treated in Fresenius Medical Care North America facilities in 2006 were followed for 1 year from the date of survey, and all hospitalization events lasting .24 hours were tracked. A depressive affect score was derived from responses to two Medical Outcomes Study Short Form 36 questions ("down in the dumps" and "downhearted and blue"). A high depressive affect score corresponded with an average response of "some of the time" or more frequent occurrence. Cox and Poisson models were constructed to determine associations of depressive affect scores with risk for time to first hospitalization and risk for hospitalization events, as well as total days spent in the hospital, respectively.Results Incident patients with high depressive affect score made up 41% of the cohort and had a median (interquartile range) hospitalization event rate of one (0, 3) and 4 (0, 15) total hospital days; the values for patients with low depressive affect scores were one (0, 2) event and 2 (0, 11) days, respectively. For high-scoring patients, the adjusted hazard ratio for first hospitalization was 1.12 (1.04, 1.20). When multiple hospital events were considered, the adjusted risk ratio was 1.13 (1.02, 1.25) and the corresponding risk ratio for total hospital days was 1.20 (1.07, 1.35). High depressive affect score was generally associated with lower physical and mental component scores, but these covariates were adjusted for in the models.Conclusions Depressive affect in incident hemodialysis patients was associated with higher risk of hospitalization and more hospital days. Future studies are needed to investigate the effect of therapeutic interventions to address depressive affect in this high-risk population.

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“…It is important to note that neuropsychological measures used in this study did assess cognitive and psychomotor domains found to be particularly impaired in ESRD patients on maintenance HD such as memory, mental efficiency, psychomotor speed, attention, and executive function [2,5,6,7,26,27]. …”

Section: Discussionmentioning

confidence: 99%

Kidney Transplantation Improves Cognitive and Psychomotor Functions in Adult Hemodialysis Patients

Radić

Ljutić²,

Radić³

et al. 2011

Am J Nephrol

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Background: Kidney failure is believed to have a negative impact on cognitive function, and cognitive impairment is common among maintenance hemodialysis (HD) patients. Previous studies have shown a beneficial effect of kidney transplantation in certain cognitive tests but not across all cognitive domains assessed. But, most of these studies performed a cross-sectional analysis, suffered from lack of standardization of adequate dialysis dose, hemoglobin level, and insufficient sensitivity of neuropsychological tests. The aim of this study was to evaluate the effect of successful kidney transplantation on cognitive and psychomotor function in adequately dialyzed HD patients without severe anemia, using sensitive neuropsychological tests. Methods: Twenty-one medically stable patients (aged 45.1 ± 7.9 years) on maintenance HD (7.6 ± 4.2 years) were investigated before and 20.5 ± 8.5 months after successful kidney transplantation using Complex Reactiometer Drenovac, a battery of computer-generated psychological tests which measure a simple visual discrimination of signal location, short-term memory, simple convergent visual orientation and convergent thinking. Results: Our findings indicated significantly better cognitive and psychomotor performance after transplantation on tests that assess processing speed, attention, short time memory, convergent thinking and executive functioning. Also, significant negative correlation between follow-up time after transplantation and cognitive and psychomotor performance in minimum time of solving test of convergent thinking was found. Conclusion: We conclude that cognitive and psychomotor functions are superior after successful kidney transplantation compared with HD, and that early beneficial effects of transplantation are not transient and cognitive and psychomotor performance might be even improved in time following successful transplantation.

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Depression and Cognitive Function in Maintenance Hemodialysis Patients

Cited by 121 publications

References 52 publications

Psychological outcomes in critically ill patients receiving renal replacement therapy: a matched‐pairs analysis

Psychological outcomes in critically ill patients receiving renal replacement therapy: a matched‐pairs analysis

Depressive Affect and Hospitalization Risk in Incident Hemodialysis Patients

Kidney Transplantation Improves Cognitive and Psychomotor Functions in Adult Hemodialysis Patients

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