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.
Department of Psychology, University of Iowa, Iowa City, IA 52242, USA.
Elizabeth A
EA
McDade-Montez
Alan J
AJ
Christensen
Jamie A
JA
Cvengros
William J
WJ
Lawton
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*