The effect of depression and health-related quality of life on the outcome of hemodialysis patients()

BACKGROUND: In hemodialysis (HD) patients, traditional risk factors cannot explain all of the mortality and morbidity. This study was designed to investigate the effect of depression and health-related quality of life (HRQOL) on prognosis in maintenance HD patients. METHODS: In February 2008, the Beck's Depression Inventory and the Kidney Dialysis Quality of Life—Short Form were utilized to measure depression and HRQOL. Until February 2011, the mortality, cardiovascular events, infection, and hospitalization were investigated, retrospectively. RESULTS: Among the 166 patients, the 3-year cumulative survival rate was 88.8%, and the depression did not affect survival (depression vs. nondepression: 91.8% vs. 87.2%, P=0.437). The upper tertiles in physical component summary (PCS) were correlated with lower mortality (OR, 0.12; P=0.05) and fewer cardiovascular events (OR, 0.09; P=0.024) than the lower tertiles. The upper tertiles in kidney disease component summary (KDCS) were associated with less hospitalization than the lower tertiles (OR, 0.38; P=0.024). After adjusting for multiple variables including age, comorbidity index, and albumin, upper tertiles in PCS were correlated with fewer cardiovascular events than the lower tertiles (OR, 0.08; P=0.038). CONCLUSION: The cross-sectional survey of whether HD patients had depression was not significantly associated with mortality and morbidity. HRQOL was correlated with mortality, cardiovascular events and hospitalization.