Kiatkriangkrai Koyratkoson
Chiang Mai University, Thailand
Title: The effect of depression on all-cause mortality and cardiovascular outcomes in peritoneal dialysis patients: A prospective cohort study
Biography
Biography: Kiatkriangkrai Koyratkoson
Abstract
Depression and mortality association is well recognized. However, studies regarding the link between depression and mortality among peritoneal dialysis (PD) are scarce. A prospective single cohort study was conducted, involving adults treated with PD within Kidney Center, General Hospital, Chiang Mai, Thailand between 15 May 2012 and 31 December 2014, and followed until 31 December 2016. Presence of depression was reported a Beck Depression Inventory (BDI) II score ≥ 14 at baseline. A sensitivity analysis was evaluated using a BDI-II threshold ≥ 20. Data on sociodemographics and risk factors for mortality were collected. Risk for all-cause mortality, CV mortality, and CV hospitalization were estimated using the multivariable Cox proportional hazards regression. 409 participants (mean age of 59.3±12.4 years, 56.0% men) were included. Of those, 117 (28.6%) reported BDI-II score ≥ 14. During the median follow-up period of 20.8 months (10,023 person-months), 139 died, of 50 were attributable to CV death. Depression were associated with all-cause mortality (adjusted hazard ratio, 2.54 [95% confidence interval, 1.87-3.64; P<0.001]), CV mortality (3.36 [1.43-7.87; P=0.005]), and CV hospitalization (2.96 [1.67-5.26; P<0.001]). For sensitivity analysis, a higher BDI-II score (≥20) were associated with all-cause mortality (3.28 [1.71-6.30; P<0.001]) and CV mortality (3.80 [1.98-7.29; P<0.001]), but not CV hospitalization (1.26 [0.48-3.30; P=0.630]). Depression is associated with a substantially increased risk of death and adverse CV outcomes in PD patients. Further studies are needed to determine whether the interventions to alleviate these symptoms would alter adverse clinical outcomes, including mortality.