Association Between Depression and Mortality in Patients Receiving Long-term Dialysis: A Systematic Review and Meta-analysis
Abstract
Background We aimed to systematically review and analyze the association between depression and mortality risk in adults with kidney failure treated by long-term dialysis. Study design A systematic review and meta-analysis of observational studies. Setting & population Patients receiving long-term dialysis. Selection criteria for studies Searching MEDLINE, EMBASE, and PsycINFO, we identified studies examining the relationship between depression, measured as depressive symptoms or clinical diagnosis, and mortality. Predictor Depression status as determined by physician diagnosis or self-reported scales. Outcomes Pooled adjusted HR and OR of depression for all-cause mortality. Results 15 of 31 included studies showed a significant association between depression and mortality, including 5 of 6 studies with more than 6,000 participants. A significant link was established between the presence of depressive symptoms and mortality (HR, 1.51; 95% CI, 1.35-1.69; I(2)=40%) based on 12 studies reporting depressive symptoms using depression scales (N=21,055; mean age, 57.6 years). After adjusting for potential publication bias, the presence of depressive symptoms remained a significant predictor of mortality (HR, 1.45; 95% CI, 1.27-1.65). In addition, combining across 6 studies reporting per-unit change in depression score (n=7,857) resulted in a significant effect (HR per unit change in score, 1.04; 95% CI, 1.01-1.06; I(2)=74%). Limitations Depression or depressive symptoms were documen…
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“Depression has been associated with all-cause mortality in other medically unwell populations and in population-based studies, suggesting similarity with our findings in the dialysis population.(86-91) A community-level systematic review reported a 2-fold increased risk of dying in depressed individuals.”
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- Authors
- Farrokhi, F., Abedi, N., Beyene, J., Kurdyak, P., & Jassal, S. V.
- Affiliations
- University of Toronto (CA)
- University of Regina (CA)
- Centre for Addiction and Mental Health (CA)
- University Health Network (CA)
- Corresponding author
- Farrokhi, Farhat
- Venue
- American Journal of Kidney Diseases
- Publisher
- Elsevier BV
- Published
- 2014-04
- Volume
- 63
- Issue
- 4
- Pages
- 623-635
- ISSN
- 0272-6386 (ISSN-L)
- OpenAlex
- W2151067656
- Cited by
- 336
- References
- 4
- Citations by year
- 2026: 17 · 2025: 30 · 2024: 31 · 2023: 33 · 2022: 41 · 2021: 38 · 2020: 25 · 2019: 30 · 2018: 26 · 2017: 15 · 2016: 24 · 2015: 15 · 2014: 7 · 2013: 1
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Kidney Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression, mortality, chronic dialysis, end-stage renal disease, depressive symptoms, all-cause mortality, depression measurement
- MeSH terms
- Adult, Depression, Renal Dialysis, Humans, Kidney Failure, Chronic, Time Factors, Observational Studies as Topic
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