Journal article
Depression Diagnoses After Living Kidney Donation: Linking US Registry Data and Administrative Claims
Transplantation, Vol.94(1), pp.77-83
07/15/2012
DOI: 10.1097/TP.0b013e318253f1bc
PMCID: PMC4447542
PMID: 22691958
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.
Details
- Title: Subtitle
- Depression Diagnoses After Living Kidney Donation: Linking US Registry Data and Administrative Claims
- Creators
- Krista L. Lentine - SalusMark A. Schnitzler - Saint Louis UniversityHuiling Xiao - Saint Louis UniversityDavid Axelrod - Dartmouth CollegeConnie L. Davis - University of WashingtonMelanie McCabe - Washington University in St. LouisDaniel C. Brennan - Washington University in St. LouisSheila Leander - Saint Louis UniversityAmit X. Garg - Western UniversityAmy D. Waterman - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- Transplantation, Vol.94(1), pp.77-83
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/TP.0b013e318253f1bc
- PMID
- 22691958
- PMCID
- PMC4447542
- ISSN
- 0041-1337
- eISSN
- 1534-6080
- Number of pages
- 7
- Grant note
- K08DK073036 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) K08DK073036; P30DK079333 / National Institute of Diabetes Digestive and Kidney Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
- Language
- English
- Date published
- 07/15/2012
- Academic Unit
- Surgery
- Record Identifier
- 9984322821902771
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