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논문분류	춘계학술대회 초록집
제목	Incident depression of kidney transplant recipients in South Korea: a long-term population-based study
저자	Yong Chul Kim, Sehoon Park, Ji Eun Kim, Mi-yeon Yu, Seon Ha Baek, Kyungdo Han, Dong Ki Kim, Kwon Wook Joo, Yon Su Kim, Hajeong Lee
출판정보	2019; 2019(1):
키워드	depression \| kidney transplant recipients \| end stage renal disease \| healthy population
초록	Depression is associated with impaired quality of life and increased morbidity and mortality in patients with ESRD and kidney transplant recipients (KTRs). Little is known about the incidence and correlates of depression in KTRs. In this study, we aimed to explore the incidence of depression in KTRs compared with ESRD patients and healthy controls (HCs) in a long-term population-based cohort. We analyzed a Nationwide Health Insurance Database of South Korea and identified patients who received KT from the year of 2007 to 2015. After exclusion of previous history of depression, KTRs were selected and matched with ESRD patients and HCs with respect to age, sex and inclusion year. KT and ESRD patients were further matched with diabetes and hypertensions. The incidence (incidence ratio, IR per 1000) of depression in KTRs was compared with ESRD patients and HCs, respectively. Among 5,148 patients in each three groups, KTRs revealed markedly decreased new-onset depression than in ESRD patients (IR, 61.3 vs 19.3; Hazard ratio [HR], 0.31; 95% confidence interval [CI], 0.28-0.35), although they showed only slightly increased incident depression than in HCs (IR, 15.1 vs 19.3; HR, 1.29; 95% CI, 1.13-1.46). Interestingly, after adjusting the comorbidity status with Charlson Comorbidity Index (CCI), KTRs showed a lower risk of incident depression compared with HCs (adjusted HR 0.68; 95% CI, 0.57-0.83, P<0.001), whereas ESRD patients remained in higher risk of depression development than HCs (adjusted HR 2.21; 95% CI, 1.85-2.64, P<0.001). Among KTRs, older age, female sex, lower socioeconomic status, and more co-morbidities represented by CCI score were associated with increased risk of depression. KTRs showed a markedly lower depression risk than ESRD patients and even than matched HCs after co-morbidities adjustment. Our data suggest a broader role of KT than previously appreciated in terms of improving quality of life by reducing depression incidence.
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