Depressive symptoms and mortality in patients after kidney transplantation: a prospective prevalent cohort study

Psychosom Med. 2010 Jul;72(6):527-34. doi: 10.1097/PSY.0b013e3181dbbb7d. Epub 2010 Apr 21.

Abstract

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).

Conclusion: Depressive symptoms are an independent predictor of mortality in kidney transplanted patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cause of Death
  • Cohort Studies
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / mortality*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Depressive Disorder / mortality
  • Female
  • Graft Rejection / epidemiology
  • Humans
  • Hungary / epidemiology
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / mortality*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prevalence
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Severity of Illness Index