In:
Clinical Transplantation, Wiley, Vol. 32, No. 10 ( 2018-10)
Abstract:
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 ), and mortality. At KT admission, 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.
Type of Medium:
Online Resource
ISSN:
0902-0063
,
1399-0012
DOI:
10.1111/ctr.2018.32.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2739458-X
detail.hit.zdb_id:
2004801-4
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