The impact of severe depression on the survival of older patients with end-stage kidney disease
- Author:
You Hyun JEON
1
;
Jeong-Hoon LIM
;
Yena JEON
;
Yu-Kyung CHUNG
;
Yon Su KIM
;
Shin-Wook KANG
;
Chul Woo YANG
;
Nam-Ho KIM
;
Hee-Yeon JUNG
;
Ji-Young CHOI
;
Sun-Hee PARK
;
Chan-Duck KIM
;
Yong-Lim KIM
;
Jang-Hee CHO
Author Information
- Publication Type:Original Article
- From:Kidney Research and Clinical Practice 2024;43(6):818-828
- CountryRepublic of Korea
- Language:English
- Abstract: Incidence of depression increases in patients with end-stage kidney disease (ESKD). We evaluated the association between depression and mortality among older patients with ESKD, which has not been studied previously. Methods: This nationwide prospective cohort study included 487 patients with ESKD aged >65 years, who were categorized into minimal, mild-to-moderate, and severe depression groups based on their Beck Depression Inventory-II (BDI-II) scores. Predisposing factors for high BDI-II scores and the association between the scores and survival were analyzed. Results: The severe depression group showed a higher modified Charlson comorbidity index value and lower serum albumin, phosphate, and uric acid levels than the other depression groups. The Kaplan-Meier curve revealed a significantly lower survival in the severe depression group than in the minimal and mild-to-moderate depression groups (p = 0.011). Multivariate Cox regression analysis confirmed that severe depression was an independent risk factor for mortality in the study cohort (hazard ratio, 1.39; 95% confidence interval, 1.01–1.91; p = 0.041). Additionally, BDI-II scores were associated with modified Charlson comorbidity index (p = 0.009) and serum albumin level (p = 0.004) in multivariate linear regression. Among the three depressive symptoms, higher somatic symptom scores were associated with increased mortality. Conclusion: Severe depression among older patients with ESKD increases mortality compared with minimal or mild-to-moderate depression, and patients with concomitant somatic symptoms require careful management of their comorbidities and nutritional status.
