Journal
CLINICAL TRANSPLANTATION
Volume 32, Issue 10, Pages -Publisher
WILEY
DOI: 10.1111/ctr.13391
Keywords
depressive symptoms; frailty; graft loss; kidney transplant recipients; kidney transplantation; mortality
Categories
Funding
- Claude Pepper Older Americans Independence Center, Johns Hopkins [P30AG021334]
- National Institute on Aging [F32AG053025, K01AG043501, R01AG042504, R01AG055781]
- National Institute of Diabetes and Digestive and Kidney Diseases [K23DK097184, K24DK101828, R01DK114074]
- NIH
Ask authors/readers for more resources
Depressive symptoms and frailty are each independently associated with morbidity and mortality in kidney transplant (KT) recipients. We hypothesized that having both depressive symptoms and frailty would be synergistic and worse than the independent effect of each. In a multicenter cohort study of 773 KT recipients, we measured the Fried frailty phenotype and the modified 18-question Center for Epidemiologic Studies-Depression Scale (CES-D). Using adjusted Poisson regression and survival analysis, we tested whether depressive symptoms (CES-D score>14) and frailty were associated with KT length of stay (LOS), death-censored graft failure(DCGF), andmortality. AtKTadmission, 10.0% of patients exhibited depressive symptoms, 16.3% were frail, and 3.6% had both. Recipients with depressive symptoms were more likely to be frail(aOR=3.97, 95% CI: 2.28-6.91, P<0.001).Recipients with both depressive symptoms and frailty had a 1.88 times (95% CI: 1.70-2.08, P<0.001) longer LOS, 6.20-fold (95% CI:1.67-22.95, P<0.01)increased risk of DCGF, and 2.62-fold(95% CI:1.03-6.70, P=0.04)increased risk of mortality, compared to those who were nonfrail and without depressive symptoms. There was only evidence of synergistic effect of frailty and depressive symptoms on length of stay (P for interaction<0.001). Interventions aimed at reducing pre-KT depressive symptoms and frailty should be explored for their impact on post-KT outcomes.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available