title: Social support predicts survival in dialysis patients.
abstract: BACKGROUND
  Social support is a consistent predictor of survival, as evidenced in empirical studies in patients with cancer or cardiovascular disease. In the area of renal diseases, this topic has not yet been studied extensively. This study, therefore, aimed to investigate the association between social support and survival for patients on dialysis.
  
  
  METHODS
  Between December 1998 and January 2002, 528 incident haemodialysis (HD) and peritoneal dialysis (PD) patients from multiple centres in The Netherlands were consecutively recruited as part of the NECOSAD-2 study. Patients completed the Social Support List (SSL) at 3 months after the start of dialysis. The SSL measured two aspects of social support: interaction and discrepancy. Cox regression analysis was used to estimate all-cause mortality risk from baseline till censor date on 1 January 2005.
  
  
  RESULTS
  Perceiving a discrepancy between expected and received social support was associated with increased mortality: social companionship (RR(adj): 1.06, 95% CI: 1.00-1.13), daily emotional support (RR(adj): 1.10, 95% CI: 1.02-1.18), and total support (RR(adj): 1.02, 95% CI: 1.00-1.04). This association was similar for PD and HD patients. Social support (interaction) was not associated with survival, neither in the whole sample nor when stratified by therapy modality.
  
  
  CONCLUSIONS
  These results point to the importance of psychosocial risk factors for mortality in patients on dialysis. More efforts are needed to improve support for these patients.
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands. S.Y.M.Thong@lumc.nl
authors.forename: Melissa S Y
authors.initials: MS
authors.lastname: Thong
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Kaptein
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Krediet
authors.forename: Elisabeth W
authors.initials: EW
authors.lastname: Boeschoten
authors.forename: Friedo W
authors.initials: FW
authors.lastname: Dekker
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D006435:Renal Dialysis / Q000401:mortality* / Q000523:psychology*; D012189:Retrospective Studies; D012944:Social Support; D015996:Survival Rate