I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on May 19, 2010, 08:55:42 PM
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Contact: LaKisha Ladson
lakisha.ladson@utsouthwestern.edu
214-648-3404
UT Southwestern Medical Center
Depressed chronic kidney disease patients more likely to face complications
DALLAS – May 20, 2010 – Patients with chronic kidney disease who have been diagnosed with depression are twice as likely to be hospitalized, progress to long-term dialysis treatments or die within a year as those who are not depressed, UT Southwestern Medical Center researchers have found.
In the study, appearing in the May 19 issue of the Journal of the American Medical Association, researchers monitored for one year 267 patients with chronic kidney disease – 56 of them with a diagnosis of a current major depressive episode, referred to here as depression, based on the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV).
Nearly 61 percent of patients with depression compared to 44 percent without depression either died, progressed to long-term dialysis, or were hospitalized within a year of observation; 55 percent of depressed patients were hospitalized compared to 40 percent of patients who were not depressed; 27 percent of depressed patients needed to start regular dialysis treatments compared to 11 percent without depression; and 9 percent of depressed individuals died compared to 6 percent without depression.
"Chronic kidney disease patients with depression have poorer health outcomes than those without depression, even after adjusting for other factors that determine poor outcomes in these patients, such as other medical diseases, anemia and low albumin levels," said Dr. Susan Hedayati, assistant professor of internal medicine at UT Southwestern, staff nephrologist at the Dallas VA Medical Center and lead author of the study. "Clinicians should consider screening chronic kidney disease patients for depression, especially since depression is also associated with poor quality of life."
Twenty-six million people in America have chronic kidney disease and millions more are at an increased risk, according to the National Kidney Foundation. If treatment does not begin early, the condition progresses to end-stage renal disease. At that point, a patient's kidneys have failed to the point where dialysis – a filtering of toxic chemicals in the blood and removal of fluid to help control blood pressure – or a kidney transplant is needed.
In 2007 an estimated $24 billion, about 6 percent of the entire Medicare budget, was spent on dialysis-related health care in patients with chronic kidney disease, according to the U.S. Renal Data System 2009 Annual Report.
This JAMA study is the first to look at outcomes as they relate to an association between chronic kidney disease and depression in patients prior to starting regular dialysis. In previous reports, Dr. Hedayati has found that one in five chronic kidney disease patients is depressed before beginning long-term dialysis therapy and that patients already on dialysis who have been diagnosed with depression are nearly twice as likely to be hospitalized or die within a year than those who are not depressed.
For the current study from May 2005 to November 2006, researchers invited patients at the Dallas VA Medical Center who were visiting the clinic for chronic kidney disease appointments to join the study. Patients who agreed to participate then underwent a structured clinical interview to determine if they had a current major depressive episode, based on the DSM-IV definition which is considered the gold-standard in evaluating depression.
Fifty-six patients were found to be depressed. The mean age of patients was about 65; two were women; and nearly 56 percent were white. All patients were veterans.
The association between chronic kidney disease, depression and poorer health outcomes held after adjusting for age, race and other current medical conditions.
"Our results support the need for well-designed clinical trials to investigate if antidepressant treatment is efficacious and safe in this vulnerable population. Patients with advanced kidney disease have been previously excluded from larger randomized trials of antidepressant medication treatment," said Dr. Hedayati, who is now conducting the Chronic Kidney Disease Antidepressant Sertraline Trial (CAST) to determine whether antidepressant medication would be tolerated in kidney-disease patients and whether such treatments can improve depression and quality of life.
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Other UT Southwestern researchers participating in this study were Dr. Abu Minhajuddin, assistant professor of clinical sciences; Dr. Masoud Afshar, a postdoctoral fellow in nephrology; Dr. Robert Toto, professor of internal medicine and clinical sciences; and Dr. Madhukar Trivedi, professor of psychiatry.
The study was supported by UT Southwestern's George M. O'Brien Kidney Research Core Center, the National Institutes of Health and the Department of Veterans Affairs.
Visit www.utsouthwestern.org/kidneys to learn more about clinical services for kidneys at UT Southwestern. Visit www.utsouthwestern.org/mentalhealth to learn more about UT Southwestern's clinical services for mental health, including psychiatry.
This news release is available on our World Wide Web home page at http://www.utsouthwestern.edu/home/news/index.html
http://www.eurekalert.org/pub_releases/2010-05/usmc-dck051910.php
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Gee, I wonder why so many kidney patients are depressed? :sarcasm;
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Is there a kidney disease patient that is not depressed?
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Is there a kidney disease patient that is not depressed?
Plenty!
The cemeteries are full of them.
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This is why we need IHD - a place where we can vent!
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That is a good attitude to have, Henry. I miss PD. I was on it for nearly 5 years and I miss the freedom it gave me.
A tip, though. If you really did want to sail solo around the world, it could be done. It just takes planning. I think as long as you had a place on the boat to store and warm your twin bags, and brought a lot of mini caps,I think you'd be fine.
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Is there a kidney disease patient that is not depressed?
I'm not depressed.
8)
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Is there a kidney disease patient that is not depressed?
Plenty!
The cemeteries are full of them.
:rofl; :rofl; :rofl;
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I have battled with Chronic Depression, along with other mental... issues... nearly all of my life, even in childhood. I believe this finding, when i was on hemo i had alot of problems. I also have really bad anxiety, and the first clinic i went to was always infultrating, i gave up and stopped going to treatments regularly, and at one point missed 2 weeks worth of treatments, before winding up in a hospital, then going to a new clinic where i had little to no problems!
Its been a year since that happened, glad to report that i am on pd, i never miss a treatment, and even before at the new clinic i tried to never miss, somedays unavoidable due to childcare issues...
Also, i still battle my demons but i think im doing better :) I take one day at a time, and remind myself to be thankful for everything i do have. I try not to dwell on the neg. Its hard, it is a stuggle, but i have faith that even though iget really down, theres only one direction to go from there ;)