Post-donation depression (PDD) and regret (PDR) remain poorly characterized for live kidney donors. Individuals who develop kidney-related medical conditions after donating may have higher odds of developing PDD or PDR.

METHODS:617 live kidney donors participated in a survey at median (IQR) 10 (7-14) years post-donation. Each participant completed a Patient Health Questionnaire-2 (PHQ-2) and answered a question to gauge PDR: "Given the chance, would you offer to donate your kidney again?" 172 individuals also completed a PHQ-9. We tested the predictive value of PHQ-2 for PHQ-9 using non-parametric ROC analysis and determined an 83% sensitivity, 98% specificity, 77% PPV, and 99% NPV.

We used individual logistic regression models – adjusted for race/sex/age – to investigate the odds of PDD in individuals with PDR, and the odds of PDD or PDR in those with new-onset morbidities (hypertension (HTN), diabetes, chronic kidney disease (CKD), and kidney stones). These morbidities were chosen for their biological relationship to donation or their severity with reduced renal biomass.

RESULTS:9% of donors scored ≥2 on the PHQ-2, indicating PDD. 25% of those who expressed PDR also exhibited PDD, versus 8.4% of those without PDR (aOR=_1.513.60_8.53 p<0.01). Donors who developed any morbidity had 2-fold higher odds of PDD (aOR=2.03, p=0.02) and those that developed HTN had 3-fold higher odds of PDD (aOR=3.08, p<0.01). There was no evidence of association between other morbidities and PDD (aOR=1.30, p=0.6 for CKD; aOR=0.99,p>0.9 for diabetes; aOR=0.65, p=0.7 for kidney stones), nor was there evidence of association between any morbidity and regret (aOR=1.24, p=0.6 for all combined; p>0.1 for each individually).

CONCLUSIONS:Post-donation development of any medical condition, new-onset HTN, and PDR are all significantly associated with PDD. These strong associations highlight the need for careful psychosocial followup of live kidney donors, particularly those who develop medical conditions after donating.

CITATION INFORMATION: Leanza J, Anjum S, Fahmy L, Bae S, Reed R, Locke J, Massie A, Segev D. Incidence of Depression Following Live Kidney Donation. Am J Transplant. 2016;16 (suppl 3).

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