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May 18, 2010JAMA

A major depressive episode in CKD patients not on dialysis was associated with an increased risk of death, dialysis initiation, or hospitalization (HR 1.86; 95% CI 1.23-2.84).

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Why the study?

Does the presence of a major depressive episode increase the risk of death, dialysis initiation, or hospitalization in outpatients with chronic kidney disease not receiving dialysis?

Population

267 consecutively recruited outpatients with chronic kidney disease at a VA medical center

Comparison

Presence of a current major depressive episode… vs Absence of a current major depressive episode

Design

Cohort, An MDE was diagnosed by blinded personnel

Follow-up

1 year

Key result

A major depressive episode in CKD patients not on dialysis was associated with an increased risk of death, dialysis initiation, or hospitalization (HR 1.86; 95% CI 1.23-2.84).

Authors

SHS. Susan Hedayati

Discussion

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Overview

May support depression screening in nondialysis CKD; leaves open whether treatment reduces events.

Study Design

Type

Cohort (n=267)

Blinding

Blinded personnel

Multicenter

No

Structured PICO

Does the presence of a major depressive episode increase the risk of death, dialysis initiation, or hospitalization in outpatients with chronic kidney disease not receiving dialysis?

P
Population
267 consecutively recruited outpatients with chronic kidney disease (stages 2-5 and who were not receiving dialysis) at a VA medical center
I
Intervention
Presence of a current major depressive episode (MDE) diagnosed using DSM-IV criteria
C
Comparator
Absence of a current major depressive episode (MDE)
O
Outcome
Event-free survival defined as the composite of death, dialysis initiation, or hospitalizationcomposite

Main Result

Effect estimate: HR 1.86 (95% CI 1.23-2.84)

Absolute Event Rate: 61% vs 44%

p-value: p=.03

In patients with CKD not on dialysis, a major depressive episode is independently associated with an increased risk of death, dialysis initiation, or hospitalization.

Cite This Study

S. Susan Hedayati (2010) conducted a cohort in Chronic kidney disease (n=267). Major depressive episode (MDE) vs. No MDE was evaluated on Composite of death, dialysis initiation, or hospitalization (HR 1.86, 95% CI 1.23-2.84, p=.03). A major depressive episode in CKD patients not on dialysis was associated with an increased risk of death, dialysis initiation, or hospitalization (HR 1.86; 95% CI 1.23-2.84).

synapsesocial.com/papers/6a1d62f61e7099f6910559dehttps://doi.org/10.1001/jama.2010.619
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