Depression increases mortality, infection risk during dialysis

  • Wu PH & al.
  • PLoS ONE
  • 1 Jan 2019

  • International Clinical Digest
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Takeaway

  • Dialysis patients with depression have a significantly higher risk for mortality and severe and fatal infections compared with patients without depression.

Why this matters

  • The findings point to the need for including mental healthcare as part of the regular medical care of patients undergoing dialysis.

Study design

  • The study evaluated 56,414 patients (age, ≥18 years) who initiated ≥90 days of chronic dialysis from the National Health Insurance Research Database of Taiwan during 2000-2007.
  • Outcomes: all-cause mortality, major adverse cardiovascular events (MACE), and severe infections.
  • Funding: Kaohsiung Medical University Hospital.

Key results

  • Mean follow-up time was 3.2 years.
  • Patients with depression had a significantly higher risk for mortality vs those without (45.29% vs 39.52%; aHR, 1.24; P<.001>
  • Patients with depression showed significant association with (all P<.001 style="list-style-type:circle;">
  • severe infections (aHR, 1.14),
  • fatal infections (aHR, 1.22),
  • sepsis (aHR, 1.19),
  • septic shock (aHR, 1.36), and
  • pneumonia (aHR, 1.19).
  • No significant difference was observed in the risk for MACE between patients with and without depression (aHR, 1.03; P=.5).
  • Limitations

    • Observational design.

    Coauthored with Antara Ghosh, PhD

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