NDT Advance Access originally published online on September 23, 2006
Nephrology Dialysis Transplantation 2007 22(1):203-208; doi:10.1093/ndt/gfl521
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Associations of race with depression and symptoms in patients on maintenance haemodialysis
1Renal Section, Medical Specialty Service Line, VA Pittsburgh Healthcare System, 2Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System and 3Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, 4Division of Renal Diseases and Hypertension, George Washington University School of Medicine, Washington, DC, 5Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine and 6Departments of Medicine and Psychiatry and the Center for Research on Health Care, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
Correspondence and offprint requests to: Steven D. Weisbord, MD, MSc VA Pittsburgh Healthcare System, Mailstop 111F-U, 7E room 120 Pittsburgh, PA 15240, USA. Email: weisbordsd{at}upmc.edu
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Abstract |
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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.
Keywords: depression; haemodialysis; spirituality; symptoms