Associations of race with depression and symptoms in patients on maintenance haemodialysis

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2007-01, Vol.22 (1), p.203-208
• Main Authors: Weisbord, Steven D., Fried, Linda F., Unruh, Mark L., Kimmel, Paul L., Switzer, Galen E., Fine, Michael J., Arnold, Robert M.
• Format: Article
• Language: English
• Subjects: African Americans; African Continental Ancestry Group; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Comorbidity; Cross-Sectional Studies; depression; Depression - ethnology; Emergency and intensive care: renal failure. Dialysis management; European Continental Ancestry Group; Female; Glomerulonephritis; haemodialysis; Humans; Intensive care medicine; Kidney Failure, Chronic - psychology; Kidney Failure, Chronic - therapy; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Quality of Life; Renal Dialysis - methods; Renal Dialysis - psychology; Renal failure; Spirituality; symptoms
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfl521

Background. Although studies have shown that African American haemodialysis patients report better overall quality of life than Whites, racial differences in depression and symptom burden remain less well characterized. The aim of this study was to compare these domains between African American and White patients on chronic haemodialysis. Methods. We surveyed African American and White maintenance haemodialysis patients. Depression was assessed using the Beck Depression Inventory (BDI) and Cognitive Depression Index (CDI). Symptoms were evaluated using the Dialysis Symptom Index (DSI). Results. Among the 82 Whites and 78 African Americans enrolled, there were no racial differences in the prevalence of depression (27% in African Americans vs 27% in Whites, P = 1.0), BDI Scores (11.2 vs 10.9, P = 0.6) or CDI scores (6.0 vs 6.0, P = 0.9). Symptom burden was substantial in both African Americans and Whites (median number of symptoms 8.5 and 9.0, respectively) with no racial differences in the overall burden or severity of symptoms. However, based on a single item, African Americans were more likely to describe their religious/spiritual beliefs as ‘very important’. Adjustment for demographic and treatment characteristics had no impact on the associations of race with depression or symptoms. Conclusions. Depression and symptoms are highly prevalent in both African American and White haemodialysis patients, without racial differences in these health-related domains. In exploratory analyses, spiritual/religious beliefs appear to be of greater importance to African Americans. The relevance of these observations to the advantages in quality of life and survival among African Americans on haemodialysis warrants further investigation.