Psychosocial Distress in Chronic Kidney Disease: Benefits of Kidney Transplantation.
1Multiorgan Transplant Program, University Health Network, Toronto, ON, Canada
2Department of Psychiatry, University Health Network, Toronto, ON, Canada
3Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, Toronto, ON, Canada
Meeting: 2017 American Transplant Congress
Abstract number: C148
Keywords: Kidney transplantation, Psychiatric comorbidity, Psychosocial, Quality of life
Session Information
Session Name: Poster Session C: Kidney Complications III
Session Type: Poster Session
Date: Monday, May 1, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Purpose
We describe the frequency of psychosocial distress among Canadian patients with advanced chronic kidney disease (CKD), and compare distress between pre-dialysis, dialysis patients and kidney transplant recipients (KTRs).
Methods
We recruited a cross-sectional convenience sample of pre-dialysis and dialysis patients from two hospital-based clinics and dialysis units; as well as stable KTRs followed at our transplant center. We used the Distress Assessment and Response Tool (DART) to assess psychosocial distress, and collected demographic information using a tablet-based electronic data capture system. The DART includes the PHQ-9 for depression, GAD-7 for anxiety and the Social Difficulties Inventory. The presence of anxiety, depression, and social difficulties was defined as a score of ≥10 on the GAD-7, PHQ-9, and SDI, respectively; any distress as a score of ≥10 on at least one of the above scales.
Results
Out of 175 patients (82 KT recipients, 26 pre-dialysis 67 dialysis); mean(±SD) age 56(±15) years, 55% male, 37% (37/82) of KT recipients and 31%(8/26) of pre-dialysis patients reported any distress, compared to 60%(40/67) of dialysis patients (p=0.006). Compared to hemodialysis patients, KT recipients had lower rates of social difficulties (34%vs.51%, p=0.049) and any distress (37%vs.58%, p=0.013); the difference between rates of depression (26%vs.18%) was not statistically significant (p=0.298). Psychosocial distress was associated with non-Caucasian ethnicity (57%vs.35%, p=0.004) with highest rates among African- (73%) and Asian-Canadians (51%). In a multivariable adjusted (age, gender, ethnicity, education, comorbidity) logistic regression model KT remained significantly associated with less psychosocial distress compared to dialysis (OR=0.42, 95%CI=0.18–0.97; P=0.043).
Conclusion:
These preliminary results suggest that psychosocial distress is very frequent among those with CKD. KT is associated with lower odds of psychosocial distress compared to patients on dialysis. A systematic approach to distress screening and management may improve psychosocial and medical outcomes for these patients.
CITATION INFORMATION: Richardson C, Belenko D, Mucsi E, Edwards N, Wong D, Novak M, Li M, Mucsi I. Psychosocial Distress in Chronic Kidney Disease: Benefits of Kidney Transplantation. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Richardson C, Belenko D, Mucsi E, Edwards N, Wong D, Novak M, Li M, Mucsi I. Psychosocial Distress in Chronic Kidney Disease: Benefits of Kidney Transplantation. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/psychosocial-distress-in-chronic-kidney-disease-benefits-of-kidney-transplantation/. Accessed November 25, 2024.« Back to 2017 American Transplant Congress