Elsevier

Transplantation Proceedings

Volume 36, Issue 1, January–February 2004, Pages 111-113
Transplantation Proceedings

Renal transplantation: outcomes
Depression levels before and after renal transplantation

https://doi.org/10.1016/j.transproceed.2003.11.021Get rights and content

Abstract

Depression is a frequent problem among end-stage renal disease patients and is closely associated with their physical well-being. We sought to compare the depression levels and confounding parameters in renal patients. The 88 patients (62 men, 26 women) included: renal transplant recipients (n = 27); renal transplant waiting list patients (n = 30); and chronic allograft rejection patients on dialysis therapy (n = 31). Their mean age was 31.05 ± 11.78 years. Age, gender, marital status, presence of chronic rejection, duration of functional graft, and hemodialysis were retrieved from patient records. Depression levels were evaluated by the Beck Depression Inventory. The depression stage of the renal transplant recipients was significantly lower than that of hemodialysis patients with chronic allograft rejection (P = .003). The presence of depression was not related to age or gender. Married patients showed a lower percentage of depression (P < .03). There was an inverse correlation between depression and functional graft duration among patients with transplant failure (r = −.370, P = .04). In conclusion, the return to hemodialysis, especially after a short duration of graft function, is associated with depression. The lower depression percentage among married patients may be due to the psychosocial support of the spouses. Therefore, single persons and transplant failure patients who return to dialysis therapy need greater social and psychologic support. Placing greater numbers of patients on transplant waiting lists decreases depression and may provide a higher quality of life with a better outcome during dialysis therapy.

Section snippets

Materials and methods

The 88 patients (62 men, 26 women of mean age 31.05 ± 11.78 years) included: renal transplant recipients (group I; n = 27); renal transplant waiting-list patients (group II; n = 30); and chronic allograft rejection patients on dialysis therapy (group III; n = 31). The patients in groups II and III were undergoing routine 4-hour hemodialysis three times per week using cuprophane membranes. Group II and III patients who showed a Kt/V < 1.4 were excluded from the study to minimize uremic effects

Results

Demographic characteristics and depression percentages of the patients are summarized in Table 1 There were 7.4% severe, 14.8% mild, and 77.8% nondepressed patients in group I; 10% severe, 20% moderate, 10% mild, and 60% nondepressed patients in group II; and 22.6% severe, 12.9% moderate, 25.8% mild, and 38.7% nondepressed patients in group III. Depression levels of the three groups were significantly different from each other (P < .01). Interestingly, we observed that the presence of

Discussion

Depression is a serious problem in ESRD patients. Numerous reports describing the relationship between depression and the outcome of ESRD patients and renal transplant recipients3, 4 suggest the importance of establishing this diagnosis. High rates of depression have been reported, particularly among hemodialysis patients.9 Because the symptoms of depression and uremia are similar, the diagnosis of depression becomes difficult.7, 10 To exclude a negative effect of ineffective dialysis on our

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