Kidney Week

Abstract: SA-PO1049

Associations Between Psychiatric Diagnoses and Kidney Transplant Outcomes

Session Information

• Transplantation: Clinical - Postkidney Transplant Outcomes and Potpourri
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Nash, Rebekah P., The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States

Rebekah P. Nash, MD, PhD

• Chen, Brian, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, United States

Brian Chen

• Ricketts, Brittania, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States

Brittania Ricketts

• Bossert, Amanda Jones, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States

Amanda Jones Bossert, MS

• Rose, Terra, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States

Terra Rose, PhD

• Richmond, Sydney B, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States

Sydney B Richmond

• Meltzer-Brody, Samantha, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States

Samantha Meltzer-Brody, MD, MPH

• Li, Yun, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States

Yun Li

• Gerber, David A., University of Cincinnati College of Medicine, Cincinnati, Ohio, United States

David A. Gerber, MD

• Flythe, Jennifer E., The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States

Jennifer E. Flythe, MD, MPH, FASN

Background

Psychiatric diagnoses are highly prevalent among kidney transplant (KT) recipients. Certain diagnoses, such as depression, have been associated with post-transplant morbidity and mortality, though these associations are inconsistent across cohorts and vary by psychiatric diagnosis.

Methods

This retrospective cohort study of adult KT recipients at a large academic transplant center used demographic, medication, laboratory, and clinical encounter data from the electronic health record (EHR). ICD codes approximated presence/absence of psychiatric diagnoses. Multivariable logistic and linear regression assessed the association between 1) pre-KT clinical factors and post-KT anxiety and depression and 2) associations between pre-KT anxiety and/or depression and post-KT re-admission, hospital length of stay (LOS), and rejection, separately.

Results

Over the study period, 814 adults (median age 53 [IQR 42,62], 55% male, 46% Black) received a KT (70% deceased donor). Post-KT anxiety and/or depression associated with pre-KT depression (OR (95% CI)=9.01 (4.46,18.97)), anxiety (OR (95% CI)=14.15 (7.02,30.49)), female gender (OR (95% CI)=1.85 (1.22,2.78)), and LOS post-KT (per day: OR (95% CI)=1.06 (1.01,1.12)). Pre-KT anxiety and/or depression associated with hospital re-admission post-KT (FigureA). Pre-KT anxiety and/or depression did not associate with post-KT LOS (FigureB) or rejection.

Conclusion

We found that pre-KT psychiatric diagnoses, medical co-morbidities and complications such as delayed graft function are associated with key post-KT outcomes. Consideration of both psychiatric and medical conditions is important to the clinical care of KT recipients.

Funding

• Other NIH Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.20255pvxxz7c