NDT Advance Access originally published online on December 12, 2006
Nephrology Dialysis Transplantation 2007 22(3):845-850; doi:10.1093/ndt/gfl700
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Social support predicts survival in dialysis patients
1Department of Clinical Epidemiology and 2Department of Medical Psychology, Leiden University Medical Centre, Leiden, 3Department of Nephrology, Academic Medical Centre, University of Amsterdam, Amsterdam and 4Hans Mak Institute, Naarden, The Netherlands
Correspondence and offprint requests to: Melissa Thong, Department of Clinical Epidemiology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands. Email: S.Y.M.Thong{at}lumc.nl
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Abstract |
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Background. Social support is a consistent predictor of survival, as evidenced in empirical studies in patients with cancer or cardiovascular disease. In the area of renal diseases, this topic has not yet been studied extensively. This study, therefore, aimed to investigate the association between social support and survival for patients on dialysis.
Methods. Between December 1998 and January 2002, 528 incident haemodialysis (HD) and peritoneal dialysis (PD) patients from multiple centres in The Netherlands were consecutively recruited as part of the NECOSAD-2 study. Patients completed the Social Support List (SSL) at 3 months after the start of dialysis. The SSL measured two aspects of social support: interaction and discrepancy. Cox regression analysis was used to estimate all-cause mortality risk from baseline till censor date on 1 January 2005.
Results. Perceiving a discrepancy between expected and received social support was associated with increased mortality: social companionship (RRadj: 1.06, 95% CI: 1.00–1.13), daily emotional support (RRadj: 1.10, 95% CI: 1.02–1.18), and total support (RRadj: 1.02, 95% CI: 1.00–1.04). This association was similar for PD and HD patients. Social support (interaction) was not associated with survival, neither in the whole sample nor when stratified by therapy modality.
Conclusions. These results point to the importance of psychosocial risk factors for mortality in patients on dialysis. More efforts are needed to improve support for these patients.
Keywords: dialysis; ESRD; mortality; social support
Received for publication: 26. 6.06
Accepted in revised form: 27.10.06
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