Multiple measurements of depression predict mortality in a longitudinal study of chronic hemodialysis outpatients

摘要: Multiple measurements of depression predict mortality in a longitudinal study chronic hemodialysis outpatients. Background The medical risk factors associated with increased (HD) patients are well known, but the psychosocial that may affect outcome have not been clearly defined. One key factor, depression, has considered predictor mortality, previous studies provided equivocal results regarding association. We sought to determine whether depressive is end-stage renal disease (ESRD) treated HD, using multiple assessments over time. Methods Two hundred ninety-five outpatients ESRD HD were recruited from three outpatient dialysis units Washington D.C. participate prospective cohort follow-up. Patients assessed every six months for up two years Beck Depression Inventory (BDI), age, serum albumin concentration, Kt/V, and protein catabolic rate (PCR). A severity index, previously demonstrated be marker, was used grade comorbidity. type dialyzer which patient noted. Patient status tracked minimum 20 maximum 60 after first interview. Cox proportional hazards models, treating scores as time-varying covariates univariable analysis, controlling comorbidity, site multivariable assess relative risk. Results mean (± SD) age our population at initial interview 54.6 ± 14.1 years. PCR 1.06 0.27 g/kg/day, Kt/V 1.2 0.4 baseline, suggesting nourished dialyzed comparably contemporary U.S. patients. patients' BDI enrollment 11.4 8.1, range mild depression. Patients' baseline level significant 38.6 In contrast, when covariate based on periodic follow-up assessments, significantly both single variable analyses. Conclusions Higher levels mortality. effects survival same order magnitude factors. Our findings controls possibly confounded analyses explain inconsistent Time-varying add power defining sensitivity establishing association mechanism underlying relationship effect interventions improve general inpatients should studied.