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Abstract: FR-PO1176

Prevalence of Depression in Kidney Transplant Recipients: A Long-Term Population-Based Study

Session Information

Category: Transplantation

  • 1901 Transplantation: Basic

Authors

  • Cho, Semin, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Park, Sehoon, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Ji Eun, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Yu, Mi-yeon, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Baek, Seon Ha, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Joo, Kwon Wook, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Yong Chul, Seoul National University Hospital, Seoul, Korea (the Republic of)
Background

Depression is associated with impaired quality of life and increased morbidity and mortality in patients with end-stage renal disease (ESRD) and kidney transplant (KT) recipients. Few data is known about the prevalence of depression in KT recipients. In this study, we aimed to explore the prevalence of depression in KT recipients compared with ESRD patients and healthy controls (HCs) in a long-term population-based cohort.

Methods

We analyzed a Nationwide Health Insurance Database of South Korea and identified patients who received KT from the year of 2007 to 2015. KT recipients were selected and matched with ESRD patients and HCs considering age, sex, and inclusion year. KT and ESRD patients were further matched with diabetes and hypertension. The prevalence (prevalence ratio, PR per 1000) of depression in KT recipients was compared with ESRD patients and HCs, respectively.

Results

A total of 7,971 patients were analyzed in all three groups, respectively. Both KT recipients and ESRD patients were poorer, having more co-morbidities than matched HCs. KT recipients revealed markedly a lower prevalence of depression than in ESRD patients (IR, 66.1 vs 23.5 per 1000 patient-year; Hazard ratio [HR], 0.36; 95% confidence interval [CI], 0.33-0.39), although they showed only slightly higher prevalence of depression than in HCs (IR, 19.4 vs 23.5; HR, 1.21; 95% CI, 1.09-1.35). Interestingly, after adjusting the comorbidity status with Charlson Comorbidity Index (CCI), KT recipients showed a lower risk of depression compared with HCs (adjusted HR 0.64; 95% CI, 0.54-0.75, P<0.001), whereas ESRD patients remained at higher risk of depression development than HCs (adjusted HR 1.80; 95% CI, 1.55-2.10, P<0.001). Among KT recipients, older age, female sex, lower socioeconomic status, and more co-morbidities represented by CCI score were associated with increased risk of depression.

Conclusion

KT recipients showed a markedly lower risk or depression than ESRD patients and even than matched HCs after adjustment of co-morbidities. Our data suggest a broader role of KT than previously appreciated in terms of improving quality of life by reducing the risk of depression.