Dataset Information

Pre-ESRD Depression and Post-ESRD Mortality in Patients with Advanced CKD Transitioning to Dialysis.

ABSTRACT:

Background and objectives

Depression in patients with nondialysis-dependent CKD is often undiagnosed, empirically overlooked, and associated with higher risk of death, progression to ESRD, and hospitalization. However, there is a paucity of evidence on the association between the presence of depression in patients with advanced nondialysis-dependent CKD and post-ESRD mortality, particularly among those in the transition period from late-stage nondialysis-dependent CKD to maintenance dialysis.

Design, setting, participants, & measurements

From a nation-wide cohort of 45,076 United States veterans who transitioned to ESRD over 4 contemporary years (November of 2007 to September of 2011), we identified 10,454 (23%) patients with a depression diagnosis during the predialysis period. We examined the association of pre-ESRD depression with all-cause mortality after transition to dialysis using Cox proportional hazards models adjusted for sociodemographics, comorbidities, and medications.

Results

Patients were 72±11 years old (mean±SD) and included 95% men, 66% patients with diabetes, and 23% blacks. The crude mortality rate was similar in patients with depression (289/1000 patient-years; 95% confidence interval, 282 to 297) versus patients without depression (286/1000 patient-years; 95% confidence interval, 282 to 290). Compared with patients without depression, patients with depression had a 6% higher all-cause mortality risk in the adjusted model (hazard ratio, 1.06; 95% confidence interval, 1.03 to 1.09). Similar results were found across all selected subgroups as well as in sensitivity analyses using alternate definitions of depression.

Conclusion

Pre-ESRD depression has a weak association with post-ESRD mortality in veterans transitioning to dialysis.

SUBMITTER: Molnar MZ

PROVIDER: S-EPMC5586564 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Publications

Pre-ESRD Depression and Post-ESRD Mortality in Patients with Advanced CKD Transitioning to Dialysis.

Molnar Miklos Z MZ Streja Elani E Sumida Keiichi K Soohoo Melissa M Ravel Vanessa A VA Gaipov Abduzhappar A Potukuchi Praveen K PK Thomas Fridtjof F Rhee Connie M CM Lu Jun Ling JL Kalantar-Zadeh Kamyar K Kovesdy Csaba P CP

Clinical journal of the American Society of Nephrology : CJASN 20170705 9

<h4>Background and objectives</h4>Depression in patients with nondialysis-dependent CKD is often undiagnosed, empirically overlooked, and associated with higher risk of death, progression to ESRD, and hospitalization. However, there is a paucity of evidence on the association between the presence of depression in patients with advanced nondialysis-dependent CKD and post-ESRD mortality, particularly among those in the transition period from late-stage nondialysis-dependent CKD to maintenance dial ...[more]

PMID: 28679562

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Dataset Information

Pre-ESRD Depression and Post-ESRD Mortality in Patients with Advanced CKD Transitioning to Dialysis.

Background and objectives

Design, setting, participants, & measurements

Results

Conclusion

Publications

Pre-ESRD Depression and Post-ESRD Mortality in Patients with Advanced CKD Transitioning to Dialysis.

Similar Datasets

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