Short-Term Versus Long-Term Effects of Depressive Symptoms on Mortality in Patients on Dialysis

Dijk, S. van; Beukel, Tessa O. van den; Dekker, Friedo W.; Cessie, Saskia le; Kaptein, Adrian A.; Honig, Adriaan; Siegert, C. E. H.; Boeschoten, Elisabeth W.; Krediet, R. T.; Verduijn, Marion

doi:10.1097/psy.0b013e31826aff0b

Cited by 14 publications

(11 citation statements)

References 37 publications

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“…As part of the Dialysis Outcomes and Practice Patterns Study, Lopes et al demonstrated that among patients on chronic hemodialysis, depression was independently associated with increased mortality and hospitalization (15). Several other studies reported similar associations as well as lower medication and dietary adherence among patients on chronic hemodialysis with depression (16)(17)(18)(19)(20)(21)(22)(23)(24). Considerably less is known about the associations of pain with clinical outcomes, although a recent study found that interdialytic pain was associated with increased mortality (25).…”

Section: Introductionmentioning

confidence: 88%

Associations of Depressive Symptoms and Pain with Dialysis Adherence, Health Resource Utilization, and Mortality in Patients Receiving Chronic Hemodialysis

Weisbord

Mor

Sevick

et al. 2014

Clinical Journal of the American Society of Nephrology

124

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Section: Introductionmentioning

confidence: 88%

Associations of Depressive Symptoms and Pain with Dialysis Adherence, Health Resource Utilization, and Mortality in Patients Receiving Chronic Hemodialysis

Weisbord

Mor

Sevick

et al. 2014

Clinical Journal of the American Society of Nephrology

124

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“…[9][10][11][12] Frailty and depression have been separately associated with higher mortality in dialysis and nondialysis populations. 1,5,[13][14][15] Among nondialysis populations, the simultaneous presence of both conditions is associated with even poorer outcomes than the presence of either condition alone. 3,16 However, the independent contributions of frailty and depression to poor outcomes have not been investigated in the hemodialysis population.…”

Section: Introductionmentioning

confidence: 99%

Depressive symptoms, frailty, and mortality among dialysis patients

McCulloch

Johansen

2019

Hemodialysis International

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Introduction: Frailty and depression are highly prevalent in the dialysis population, but the association between them, the risk factors for their development, and their independent associations with mortality have not been studied. Methods: We examined 771 patients enrolled in the ACTIVE/ADIPOSE prevalent dialysis cohort study. Fried’s frailty phenotype and the Center for Epidemiologic Studies Depression score were used to determine frailty and presence of depressive symptoms, respectively. We assessed the baseline association between frailty and depressive symptoms, whether one entity is a risk factor for development of the other, and associations between frailty and depressive symptoms with mortality. Findings: At baseline, 13.1% of our population screened positive for depressive symptoms, 21.8% met criteria for frailty, and 10.0% met criteria for both. During follow-up, 26.6% of our population developed frailty and 12.7% developed depressive symptoms. Using multivariable logistic regression, baseline depressive symptoms were associated with 2.14-fold higher odds of being frail at baseline (95% confidence interval [CI] 1.45–3.17) and with a 2.16-fold higher odds of incident frailty during follow-up (95% CI 1.22–3.82). However, baseline frailty was not associated with incident depressive symptoms. Frailty and depressive symptoms were independent predictors of mortality in time-varying survival analysis (meeting frailty criteria: hazard ratio [HR] 1.53, 95% CI 1.05–2.23; depressive symptoms: HR 2.21,95% CI 1.50–3.25). Discussion: Frailty and depressive symptoms remained highly prevalent over time and were strongly associated with one another and independently associated with mortality among dialysis patients. Future studies should investigate whether interventions for depression could potentially mitigate the appearance of frailty and its associated poor outcomes.

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“…Chronic dialysis patients are known for the presence of a chronic inflammatory state 1 and for a high prevalence of depressive symptoms 2 . Depressive symptoms are associated with morbidity and both short-term and long-term mortality in dialysis patients [3][4][5][6] . Also higher levels of inflammation markers (especially CRP) have been found to be associated with both higher morbidity and mortality 7-10 .…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Associations Between Inflammation and Depressive Symptoms in Chronic Dialysis Patients

et al. 2019

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ObjectivePatients undergoing chronic dialysis often display sustained elevations of inflammation markers and also have a high prevalence of depressive symptoms. Although multiple studies demonstrated cross-sectional associations between inflammation markers and depressive symptoms in this patient group, longitudinal associations have not been examined. We therefore investigated whether longitudinal associations exist between inflammation markers and depressive symptoms in chronic dialysis patients. MethodsData of three consecutive measurements of an observational, prospective cohort study among chronic dialysis patients were used. At baseline, 6 months and 12 months follow-up, patients completed the Beck Depression Inventory (BDI) and inflammation markers (HsCRP, IL-1β, IL-6, IL-10, and TNFα) were measured. We examined cross-sectional associations between inflammation markers and depressive symptoms using linear regression models. The longitudinal association between inflammation and depressive symptoms was assessed using a linear mixed model analyses. ResultsA total of 513 patients were included. Cross-sectional associations were found between HsCRP and depressive symptoms at baseline (β= 0.9 (CI: 0.4-1.4)) and 6 months follow-up (β= 1.1 (CI: 0.3-2.0)), and between IL-1β and depressive symptoms at 6 months follow-up (β= 1.3 (CI: 0.8-

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Short-Term Versus Long-Term Effects of Depressive Symptoms on Mortality in Patients on Dialysis

Abstract: Depressive symptoms at the start of dialysis therapy are associated with short-, medium-, and long-term mortality. The cause-specific mortality risk over time may help clinicians to understand multifactorial causes of the association between depressive symptoms and survival.

Cited by 14 publications

References 37 publications

Associations of Depressive Symptoms and Pain with Dialysis Adherence, Health Resource Utilization, and Mortality in Patients Receiving Chronic Hemodialysis

Associations of Depressive Symptoms and Pain with Dialysis Adherence, Health Resource Utilization, and Mortality in Patients Receiving Chronic Hemodialysis

Depressive symptoms, frailty, and mortality among dialysis patients

Longitudinal Associations Between Inflammation and Depressive Symptoms in Chronic Dialysis Patients

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