The negative impact of depressive symptoms on patient and technique survival in peritoneal dialysis: a prospective cohor
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NEPHROLOGY - ORIGINAL PAPER
The negative impact of depressive symptoms on patient and technique survival in peritoneal dialysis: a prospective cohort study Jianxiong Lin1,2 · Hongjian Ye1,2 · Chunyan Yi1,2 · Jianying Li1,2 · Xiaoli Yu1,2 · Lina Zhu1,2 · Xiaodan Zhang1,2 · Xiaofeng Wu1,2 · Haiping Mao1,2 · Xueqing Yu1,2 · Xiao Yang1,2 Received: 6 April 2020 / Accepted: 30 July 2020 © Springer Nature B.V. 2020
Abstract Purpose The relationship between depression and long-term clinical outcomes in peritoneal dialysis is unclear. This study was to explore the effect of depressive symptoms on patient survival and technique survival in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods Patients who had received CAPD therapy for ≥ 3 months were recruited from January to June, 2009, with follow-up until June, 2019. The Beck Depression Inventory-II (BDI-II) was used to evaluate depressive symptoms (BDI scores ≥ 14) at baseline. The primary outcome was all-cause mortality, and the secondary outcome was technique failure. Results Participants were 275 CAPD patients (mean age 49.6 ± 15.9 years, male 54.2%). Of these, 86 (31.3%) experienced depressive symptoms. The depressive group had fewer males, longer PD duration at enrollment, higher calcium levels, and lower residual glomerular filtration rates (all P 5 year follow-up [13]. Additionally, the effect of depression on technical failure in PD patients is unclear. Owing to the difficulties in making a depression
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diagnosis in dialysis patients in clinical practice, our study focused on the depressive symptoms of PD patients. Therefore, we conducted this prospective cohort study with a large sample of PD patients to explore factors associated with depressive symptoms, and the long-term impacts of depressive symptoms on all-cause mortality and technique failure.
Methods Patient recruitment This was a prospective cohort study. We recruited patients receiving continuous ambulatory PD (CAPD) treatment at our PD center between January 1 and June 30, 2009. The inclusion criteria were (1) has received CAPD for ≥ 3 months; (2) age ≥ 18 years; (3) willingness to participate in the study and provide written informed consent. The exclusion criteria were (1) age 11, > 12, respectively) was done to confirm which cutoff was better in this study. BDI-II was used to assess depressive symptoms by a well-trained nurse during clinic follow-up.
Demographic and baseline laboratory data The following demographic data were collected at baseline: age, gender, education level, comorbidity conditions, PD duration at enrollment, and primary cause of renal disease. The following baseline laboratory data were collected from patient charts at recruitment: hemoglobin, serum albumin, serum calcium, serum phosphorus, intact parathyroid
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International Urology and Nephrology
hormone (iPTH), serum sodium, serum potassium, high-sensitivity C-reactive protein, and dialysis adequacy, including Kt/V (reflects the total urea clearance both in peritoneal dialys
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