Risk factors for depression after kidney transplantation.
OBJECTIVE
Kidney transplantation is recognized as the only potentially curative treatment for end-stage renal failure. But many psychiatric problems are associated with the procedure. The purpose of this study was to identify predictors of a risk for depression after kidney transplantation.


METHODS
This retrospective cohort study recruited 116 first kidney-only Japanese recipients whose mean age was 50.2 +/- 11.87 years include a male/female ratio of 63/53. They underwent transplantation between 1990 and 2008. At enrollment, we used the Zung Self-rating Depression Scale score as well as characterized demographic and clinical features of recipients and donors. Comparisons between depressed and non-depressed patients concerning sociodemographic and clinical characteristics were used chi(2) tests for categorical variables and Student's t-tests for continuous variables. Risk factors with significant correlation coefficients (P < .05) were entered into a stepwise logistic regression model to identify the best single risk factor for depression after kidney transplantation.


RESULTS
The prevalence of depression in this study was 41.4%. Depressed patients were significantly more likely to not have regular incomes, nor to have desired kidney transplantation, to have experienced a rejection episode, and to live alone (P < .05). The single best predictor of future depression was living alone; subjects living alone were 2.51 times more likely to be depressed as those living with others (adjusted odds ratio [OR], 2.51; 95% confidence interval [CI], 1.31-5.22; P < .05).


CONCLUSIONS
Although depression after kidney transplantation is driven by multiple, complex, and often overlapping risk factors, we observed characteristic features of recipients including their social environment and follow-up treatment.
Tsunoda
T
T
Department of Medicine Japan Self-Defense Force Fukuoka Hospital, Kasuga City, Fukuoka, Japan.
Yamashita
R
R
Kojima
Y
Y
Takahara
S
S
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D015331:Cohort Studies; D003863:Depression / Q000145:classification / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006084:Graft Rejection / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects / Q000523:psychology*; D007902:Length of Stay; D008019:Life Style; D019520:Living Donors / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011203:Poverty; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors / Q000706:statistics & numerical data