Is depression a risk factor for mortality in chronic hemodialysis patients?

• Autor(a) principal: Diefenthaeler,Edgar C
• Data de Publicação: 2008
• Outros Autores: Wagner,Mário Bernardes, Poli-de-Figueiredo,Carlos Eduardo, Zimmermann,Paulo R, Saitovitch,David
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Brazilian Journal of Psychiatry (São Paulo. 1999. Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462008000200003
• topic: Kidney failure; Renal dialysis; Proportional hazards model; Depression; Mortality

OBJECTIVE: The present study was conducted to assess the association between depressive symptomatology and mortality in chronic hemodialysis. METHOD: A cohort of 40 patients was followed for a median period of 10.5 months. The Beck Depression Inventory was used to classify patients as exposed to depression (Beck Depression Inventory score > 14) or not (Beck Depression Inventory < 14). Kaplan-Meier survival curves were used to compare the mortality rate between the two groups. The effects of potential confounding factors were adjusted using Cox proportional hazards model. RESULTS: After 24 months of follow-up, survival rates were 39% for exposed and 95% for non-exposed patients (p = 0.029). The Cox proportional hazards model showed results similar to those of the bivariate analysis, indicating that depressive symptomatology tended to be associated with mortality (HR = 6.5, 95%CI: 0.8-55.6; p = 0.085). Other study variables, including age, concurrent systemic diseases, and biochemical markers, were not significantly associated with mortality. Exposed patients remained on dialysis longer and received kidney transplants less frequently (9% vs. 50% for non-exposed patients). When kidney transplantation was included in the Cox regression model, the hazard ratio of mortality for exposed as compared to non-exposed patients lost statistical significance (HR = 4.5; 95%CI: 0.5-40.0; p = 0.17). CONCLUSIONS: Our study suggests that the presence of depressive symptoms may act as an independent risk factor for mortality in chronic hemodialysis patients. However, this finding needs further investigations.