The role of depression symptoms in dialysis withdrawal.
Among end-stage renal disease (ESRD) patients on hemodialysis, death from withdrawal from life-sustaining dialysis is increasingly common. The present study's objective was to examine depression as a potential risk factor for hemodialysis withdrawal. Two hundred forty ESRD hemodialysis (133 male and 107 female) patients were followed for an average of 4 years after depression symptom assessment. Of these, 18% withdrew from dialysis. Using multivariate survival analysis and after controlling for the effects of age (p < .001) and clinical variables, the authors found that level of depression symptoms was a unique and significant predictive risk factor for the subsequent decision to withdraw from dialysis (p < .05). The potential impact that depression may have on the decision to withdraw from hemodialysis should be considered by health care providers, patient families, and patients.
McDade-Montez
Elizabeth A
EA
Department of Psychology, University of Iowa, Iowa City, IA 52242, USA.
Christensen
Alan J
AJ
Cvengros
Jamie A
JA
Lawton
William J
WJ
D000328:Adult; D000368:Aged; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000523:psychology* / Q000706:statistics & numerical data; D016019:Survival Analysis; D016312:Treatment Refusal / Q000523:psychology*