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Kidney Week

Abstract: SA-PO042

Beck Depression Index-II Scores and Survival in a Multi-Center Prospective Hemodialysis Cohort

Session Information

Category: Diversity and Equity in Kidney Health

  • 900 Diversity and Equity in Kidney Health

Authors

  • Yoon, Ji Hoon, University of California Irvine School of Medicine, Irvine, California, United States
  • Narasaki, Yoko, University of California Irvine School of Medicine, Irvine, California, United States
  • Siu, Man Kit Michael, University of California Irvine School of Medicine, Irvine, California, United States
  • You, Seungsook, University of California Irvine School of Medicine, Irvine, California, United States
  • Nguyen, Matthew Duy Thanh Luyen, University of California Irvine School of Medicine, Irvine, California, United States
  • Kalantar, Diana Sunhee, University of California Irvine School of Medicine, Irvine, California, United States
  • Le, Lisa, University of California Irvine School of Medicine, Irvine, California, United States
  • Nguyen, Danh V., University of California Irvine School of Medicine, Irvine, California, United States
  • Kalantar-Zadeh, Kamyar, Harbor-UCLA Medical Center, Torrance, California, United States
  • Rhee, Connie, University of California Irvine School of Medicine, Irvine, California, United States
Background

Population-based studies have uncovered a high burden of depression among advanced CKD patients, including those receiving dialysis. We examined the relationship between self-reported depression and mortality among a diverse multi-center prospective cohort of HD patients.

Methods

We evaluated 956 HD patients from the prospective NIH MADRAD Study recruited across 18 dialysis clinics across Southern California who underwent protocolized Beck Depression Index-II (BDI-II) surveys over 2011-2021. Using multivariable Cox models adjusted for expanded case-mix covariates, we examined associations of time-dependent BDI-II score categorized as tertiles with all-cause mortality risk. We then examined differential BDI-II score—mortality associations across race/ethnicity using interaction tests.

Results

The mean±SD age of the cohort was 55±14 years, among whom 45% were female; 29% were Black; and 55% were Hispanic. In analyses of time-dependent BDI-II score, the highest (worse) Tertile 3 was associated with higher death risk (ref: Tertile 1): HR (95%CI) 1.40 (1.08, 1.81) (Fig A). Subgroup analyses showed that point estimates for the highest Tertile 3 of BDI-II scores was associated with higher mortality in Black vs. Non-Black patients (HRs [95%CIs] 1.30 [0.81, 2.08] and 1.18 [0.87, 1.61]) and in Hispanic vs. Non-Hispanic patients (HRs [95%CIs] 1.18 [0.83, 1.68] and 1.25 [0.86, 1.82]), with non-significant p-interaction values suggesting equivalent risk across race/ethnicity (Fig B).

Conclusion

In a multicenter prospective HD cohort, higher (worse) BDI-II scores were associated with worse survival in all racial/ethnic groups. Further studies are needed to identify multi-modal strategies that effectively treat depression in diverse HD populations.

Funding

  • NIDDK Support