Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Depressed chronic kidney disease patients more likely to face complications

20.05.2010
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.

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

To automatically receive news releases from UT Southwestern via e-mail, subscribe at www.utsouthwestern.edu/receivenews

LaKisha Ladson | EurekAlert!
Further information:
http://www.utsouthwestern.edu

More articles from Studies and Analyses:

nachricht Smart Data Transformation – Surfing the Big Wave
02.12.2016 | Fraunhofer-Institut für Angewandte Informationstechnik FIT

nachricht Climate change could outpace EPA Lake Champlain protections
18.11.2016 | University of Vermont

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

Im Focus: MADMAX: Max Planck Institute for Physics takes up axion research

The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.

The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...

Im Focus: Molecules change shape when wet

Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water

In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...

Im Focus: Fraunhofer ISE Develops Highly Compact, High Frequency DC/DC Converter for Aviation

The efficiency of power electronic systems is not solely dependent on electrical efficiency but also on weight, for example, in mobile systems. When the weight of relevant components and devices in airplanes, for instance, is reduced, fuel savings can be achieved and correspondingly greenhouse gas emissions decreased. New materials and components based on gallium nitride (GaN) can help to reduce weight and increase the efficiency. With these new materials, power electronic switches can be operated at higher switching frequency, resulting in higher power density and lower material costs.

Researchers at the Fraunhofer Institute for Solar Energy Systems ISE together with partners have investigated how these materials can be used to make power...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

UTSA study describes new minimally invasive device to treat cancer and other illnesses

02.12.2016 | Medical Engineering

Plasma-zapping process could yield trans fat-free soybean oil product

02.12.2016 | Agricultural and Forestry Science

What do Netflix, Google and planetary systems have in common?

02.12.2016 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>