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A Prospective Study of Depression and Quality of Life after Kidney Transplantation. | LitMetric

AI Article Synopsis

  • Kidney transplantation positively impacts both depression and health-related quality of life (HRQOL), with benefits lasting beyond the early post-transplant phase.
  • Younger patients experience a greater improvement in the physical component of HRQOL compared to older patients, although all ages see a reduction in depression levels.
  • The study used longitudinal assessments over time to analyze the changes in depression and HRQOL among kidney transplant recipients, highlighting significant improvements after transplantation.

Article Abstract

Key Points: Depression and health-related quality of life improve with kidney transplantation and is sustained beyond the immediate post-transplant period. The improvement in health-related quality of life, especially the physical component, differs by age and is higher in younger patients. Depression improves in all kidney transplantation recipients, irrespective of their age.

Background: Depression and diminished health-related quality of life (HRQOL) are common in kidney failure. In this study, we investigate whether kidney transplantation (KT), the treatment of choice for kidney failure, improves depression and HRQOL across lifespan and whether this effect is sustained.

Methods: In this longitudinal observational cohort study, we assessed depression and HRQOL in patients on the KT waitlist and again at 3 months and 1 year after KT. We measured depression using the Beck Depression Inventory-II (BDI-II) and HRQOL using the Kidney Disease Quality of Life Short Form Version 1.3 physical health composite score (PCS) and mental health composite score (MCS). We used linear mixed-effects models with random intercepts for patients to evaluate the effect of time, age, and KT status on BDI-II score, PCS, and MCS. For models with significant age interactions, we estimated this effect for baseline age groups.

Results: We analyzed 239 longitudinal BDI-II assessments completed by 99 patients and 143 Kidney Disease Quality of Life Short Form Version 1.3 assessments completed by 59 patients (16% Black, 79% White). The BDI-II scores improved pre- to post-KT (10 pre-KT versus five post-KT, < 0.001). PCS improved pre- to post-KT in younger patients, but the magnitude of change was lower with older age ( for interaction=0.01). In the subgroup analysis by age, there was improvement in PCS post-KT in patients younger than 60 years ( = 0.003 for 30–39, = 0.007 for 40–49, = 0.03 for 50–59). The MCS also improved from 47 pre-KT to 51 post-KT ( < 0.001), and the magnitude of improvement was again lower with older age ( for interaction=0.03).

Conclusions: Depression and HRQOL improve with KT. While depression improves in all ages, the improvement in HRQOL, especially PCS, is more evident in younger patients. This improvement in depression and HRQOL is sustained until at least 1 year post-KT. These data help frame expectations for patients and transplant teams.

Podcast: This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/K360/2024_09_26_KID0000000000000538.mp3

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441810PMC
http://dx.doi.org/10.34067/KID.0000000000000538DOI Listing

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