Depression ups risk of poor kidney transplant outcome

NEW YORK (Reuters Health) - Among kidney transplant recipients, depression doubles the risk of kidney failure, return to dialysis therapy, and death, new research indicates.

"Concerns about transplant rejection, fear of infection, readjustment to everyday life, and use of immunosuppressive medications, with frequent and often severe adverse effects" can lead to emotional problems in the early years after kidney transplantation, the research team notes in the current issue of the American Journal of Kidney Diseases.

However, the consequences of developing depression in this patient population are unclear.

To look into this issue, Dr. Fabienne Dobbels from Katholieke Universiteit Leuven in Belgium and associates identified 47,899 patients who had a kidney transplanted between 1995 and 2003.

Records showed that the cumulative incidence of depression was roughly 7 percent 1 year after kidney transplantation; it was 11 percent and 13 percent, respectively, 2 and 3 years post-transplantation.

Kidney failure occurred in 19 percent of patients, 8 percent died with a functioning kidney, and approximately 11 percent had to go back to dialysis therapy,.

According to the researchers, depression was associated with about a two-fold increased risk of each of these adverse outcomes.

"Depression after kidney transplantation is a serious condition associated with poor clinical outcomes," Dobbels and colleagues conclude. Therefore, depression screening and periodic reassessment "is of crucial importance to determine which patients should be referred for specialized mental health treatment."

SOURCE: American Journal of Kidney Diseases, May 2008.