Depression Diagnoses After Living Kidney Donation
- 15 July 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Transplantation
- Vol. 94 (1), 77-83
- https://doi.org/10.1097/tp.0b013e318253f1bc
Abstract
Background Limited data exist on correlates of psychological outcomes after kidney donation. Methods We used a database integrating Organ Procurement and Transplantation Network registrations for 4650 living kidney donors from 1987 to 2007 with administrative data of a U.S. private health insurer (2000–2007 claims) to identify depression diagnoses among prior living donors. The burden and demographic correlates of depression after enrollment in the insurance plan were estimated by Cox regression. Graft failure and death of the donor’s recipient were examined as time-varying exposures. Results After start of insurance benefits, the cumulative frequency of depression diagnosis was 4.2% at 1 year and 11.5% at 5 years, and depression among donors was less common than among age- and gender-matched general insurance beneficiaries (rate ratio, 0.70; 95% confidence intervals [CI], 0.60–0.81). Demographic and clinical correlates of increased likelihood of depression diagnoses among the prior donors included female gender, white race, and some perioperative complications. After adjustment for donor demographic factors, recipient death (adjusted hazard ratio (aHR), 2.23; 95% CI, 1.11–4.48) and death-censored graft failure (aHR, 3.30; 95% CI, 1.49–7.34) were associated with two to three times the relative risk of subsequent depression diagnosis among nonspousal unrelated donors. There were trends toward increased depression diagnoses after recipient death and graft failure among spousal donors but no evidence of associations of these recipient events with the likelihood of depression diagnosis among related donors. Conclusions Recipient death and graft loss predict increased depression risk among unrelated living donors in this privately insured sample. Informed consent and postdonation care should consider the potential impact of recipient outcomes on the psychological health of the donor.Keywords
This publication has 21 references indexed in Scilit:
- The Long-Term Quality of Life of Living Kidney Donors: A Multicenter Cohort StudyAmerican Journal of Transplantation, 2011
- The impact of kidney transplantation on heart failure risk varies with candidate body mass indexAmerican Heart Journal, 2009
- Long-Term Consequences of Kidney DonationNew England Journal of Medicine, 2009
- Follow‐up interviews of 12 living kidney donors one yr after open donor nephrectomyClinical Transplantation, 2007
- Psychosocial Health of Living Kidney Donors: A Systematic ReviewAmerican Journal of Transplantation, 2006
- Prospective Psychosocial Evaluation of Related Kidney Donors: Indian PerspectiveTransplantation Proceedings, 2005
- Prevalence of Depression by Race/Ethnicity: Findings From the National Health and Nutrition Examination Survey IIIAmerican Journal of Public Health, 2005
- “Paradoxical Depression” in a Living Female Donor After Kidney TransplantationPsychosomatics, 1998
- The Psychosocial Impact of Donating a Kidney: Long-Term Followup from a Urology Based CenterJournal of Urology, 1997
- Editorial CommentJournal of Urology, 1997