Depressive symptoms and mortality in patients after kidney transplantation: a prospective prevalent cohort study.
OBJECTIVE
To analyze in a prospective cohort study if depressive symptoms are an independent predictor of mortality in kidney transplant recipients.


METHODS
Data from 840 transplanted patients followed at a single outpatient transplant center were analyzed. Sociodemographic parameters and clinical data were collected at enrollment (between August 2002 and February 2003). Participants completed the Center for Epidemiologic Studies-Depression (CES-D) scale. Depression was defined as CES-D score of > or = 18. Data on 5-year outcomes (death censored graft loss or mortality) were collected.


RESULTS
The prevalence of depression was 22%. Mortality was higher (21% versus 13%; p = .004) in patients with versus without depression. In a multivariate Cox proportional hazard model, both the baseline CES-D score (hazard ratio(for each 1-point increase) = 1.02; 95% confidence interval, 1.00-1.04) and the presence of depression at baseline (hazard ratio(presence) = 1.66; 95% confidence interval, 1.12-2.47) were significantly associated with mortality. The baseline CES-D score also significantly predicted death censored graft loss (hazard ratio(for each 1-point increase) = 1.03; 95% confidence interval, 1.01-1.05).


CONCLUSIONS
Depressive symptoms are an independent predictor of mortality in kidney transplanted patients.
Novak
Marta
M
Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary. marta@nefros.net
Molnar
Miklos Zsolt
MZ
Szeifert
Lilla
L
Kovacs
Agnes Zsofia
AZ
Vamos
Eszter Panna
EP
Zoller
Rezso
R
Keszei
Andras
A
Mucsi
Istvan
I
D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index