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Depression does not predict clinical outcome of Chinese peritoneal Dialysis patients after adjusting for the degree of frailty
BACKGROUND: Depression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients. However, the interaction between depression and frailty in PD patients remains uncertain. We determined the prevalence of depression and frailty in prevalent Chinese PD patients, disse...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7405374/ https://www.ncbi.nlm.nih.gov/pubmed/32758180 http://dx.doi.org/10.1186/s12882-020-01994-4 |
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author | Chan, Gordon Chun-Kau Ng, Jack Kit-Chung Chow, Kai-Ming Kwan, Bonnie Ching-Ha Kwong, Vickie Wai-Ki Pang, Wing-Fai Cheng, Phyllis Mei-Shan Law, Man-Ching Leung, Chi-Bon Li, Philip Kam-Tao Szeto, Cheuk-Chun |
author_facet | Chan, Gordon Chun-Kau Ng, Jack Kit-Chung Chow, Kai-Ming Kwan, Bonnie Ching-Ha Kwong, Vickie Wai-Ki Pang, Wing-Fai Cheng, Phyllis Mei-Shan Law, Man-Ching Leung, Chi-Bon Li, Philip Kam-Tao Szeto, Cheuk-Chun |
author_sort | Chan, Gordon Chun-Kau |
collection | PubMed |
description | BACKGROUND: Depression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients. However, the interaction between depression and frailty in PD patients remains uncertain. We determined the prevalence of depression and frailty in prevalent Chinese PD patients, dissected the internal relationship between depression and frailty, and determined their relative contribution to the adverse clinical outcome in PD patients. METHODS: In a prospective observational study, we recruited 267 prevalent PD patients. Depression was identified by Patient Health Questionnaire (PHQ-9). Frailty was identified by a validated Frailty Score. All cases were followed for one year. Outcome measures included number and duration of hospitalization, peritonitis rate, and all-cause mortality. RESULTS: Of the 267 patients, 197 patients (73.8%) were depressed, and 157 (58.8%) were frail. There was a substantial overlap between depression and frailty. Although depression and frailty were associated the number and duration of hospitalization by univariate analysis, the association became insignificant after adjusting for confounding factors by multivariate analysis. Both depression and frailty were associated with one-year mortality by univariate analysis. One-year patient survival was 95.9, 86.5, 82.4 and 71.0% for patients with nil, mild, moderate and severe frailty, respectively (p = 0.001). Frailty was an independent predictor of patient survival by multivariate analysis (adjusted hazard ratio 1.424, 95% confidence interval 1.011–2.005. p = 0.043), while the prognostic effect of depression disappears after adjusting for frailty score. CONCLUSION: Depression and frailty were common among Chinese PD patients. Frailty, but not depression, was an independent predictor of one-year mortality. |
format | Online Article Text |
id | pubmed-7405374 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-74053742020-08-07 Depression does not predict clinical outcome of Chinese peritoneal Dialysis patients after adjusting for the degree of frailty Chan, Gordon Chun-Kau Ng, Jack Kit-Chung Chow, Kai-Ming Kwan, Bonnie Ching-Ha Kwong, Vickie Wai-Ki Pang, Wing-Fai Cheng, Phyllis Mei-Shan Law, Man-Ching Leung, Chi-Bon Li, Philip Kam-Tao Szeto, Cheuk-Chun BMC Nephrol Research Article BACKGROUND: Depression and frailty contribute to the adverse clinical outcome of peritoneal dialysis (PD) patients. However, the interaction between depression and frailty in PD patients remains uncertain. We determined the prevalence of depression and frailty in prevalent Chinese PD patients, dissected the internal relationship between depression and frailty, and determined their relative contribution to the adverse clinical outcome in PD patients. METHODS: In a prospective observational study, we recruited 267 prevalent PD patients. Depression was identified by Patient Health Questionnaire (PHQ-9). Frailty was identified by a validated Frailty Score. All cases were followed for one year. Outcome measures included number and duration of hospitalization, peritonitis rate, and all-cause mortality. RESULTS: Of the 267 patients, 197 patients (73.8%) were depressed, and 157 (58.8%) were frail. There was a substantial overlap between depression and frailty. Although depression and frailty were associated the number and duration of hospitalization by univariate analysis, the association became insignificant after adjusting for confounding factors by multivariate analysis. Both depression and frailty were associated with one-year mortality by univariate analysis. One-year patient survival was 95.9, 86.5, 82.4 and 71.0% for patients with nil, mild, moderate and severe frailty, respectively (p = 0.001). Frailty was an independent predictor of patient survival by multivariate analysis (adjusted hazard ratio 1.424, 95% confidence interval 1.011–2.005. p = 0.043), while the prognostic effect of depression disappears after adjusting for frailty score. CONCLUSION: Depression and frailty were common among Chinese PD patients. Frailty, but not depression, was an independent predictor of one-year mortality. BioMed Central 2020-08-05 /pmc/articles/PMC7405374/ /pubmed/32758180 http://dx.doi.org/10.1186/s12882-020-01994-4 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Chan, Gordon Chun-Kau Ng, Jack Kit-Chung Chow, Kai-Ming Kwan, Bonnie Ching-Ha Kwong, Vickie Wai-Ki Pang, Wing-Fai Cheng, Phyllis Mei-Shan Law, Man-Ching Leung, Chi-Bon Li, Philip Kam-Tao Szeto, Cheuk-Chun Depression does not predict clinical outcome of Chinese peritoneal Dialysis patients after adjusting for the degree of frailty |
title | Depression does not predict clinical outcome of Chinese peritoneal Dialysis patients after adjusting for the degree of frailty |
title_full | Depression does not predict clinical outcome of Chinese peritoneal Dialysis patients after adjusting for the degree of frailty |
title_fullStr | Depression does not predict clinical outcome of Chinese peritoneal Dialysis patients after adjusting for the degree of frailty |
title_full_unstemmed | Depression does not predict clinical outcome of Chinese peritoneal Dialysis patients after adjusting for the degree of frailty |
title_short | Depression does not predict clinical outcome of Chinese peritoneal Dialysis patients after adjusting for the degree of frailty |
title_sort | depression does not predict clinical outcome of chinese peritoneal dialysis patients after adjusting for the degree of frailty |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7405374/ https://www.ncbi.nlm.nih.gov/pubmed/32758180 http://dx.doi.org/10.1186/s12882-020-01994-4 |
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