Abstract: FR-PO661
Prevalence and Outcome Impact of Depression and Frailty Among Peritoneal Dialysis Population in a Local Dialysis Centre
Session Information
- Dialysis: Peritoneal Dialysis - II
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Chan, Gordon Ck, Prince of Wales Hospital, Hong Kong, China
- Szeto, Cheuk-Chun, The Chinese University of Hong Kong, Shatin, HONG KONG, China
Background
Depression and frailty are increasingly being recognized as contributing factors to the adverse clinical outcome of peritoneal dialysis (PD) patients. Depressed patients have multiple physical and psychological symptoms, and have poor adherence to dialysis and medical therapy. Frailty refers to a state of increased vulnerability caused by decline in physical reserve and function, and is caused by malnutrition, chronic inflammation, and repeated infection. However, the interaction between depression and frailty in PD patients remains uncertain. We determine the prevalence of depression and frailty in prevalent PD patients. We further dissect the internal relationship between depression and frailty, and their relative contribution to the adverse clinical outcome in PD patients.
Methods
This is a prospective observational study. We recruited 267 prevalent PD patients between 2015 and 2016. 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 hospitalisation, 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 hospitalisation 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, but only 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).
Conclusion
Depression and frailty were common among Chinese PD patients. Frailty, but not depression, was an independent predictor of one-year mortality. Further studies are needed to determine the benefit of treatment for frailty in PD patients.
Funding
- Government Support - Non-U.S.