Apathy, Depression, and Hemodialysis Adherence in African American Patients
Recommended Citation
Roche MS, Wild MG, Mahfouz RT, Rajagopal A, Osorio LG, Najjar Mojarrab J, Henry-Okafor Q, Liddell T, Fissell RB, Nair D, Prigmore HL, Greevy R, Cavanaugh KL, Tindle HA, Umeukeje EM. Apathy, Depression, and Hemodialysis Adherence in African American Patients. J Am Soc Nephrol 2024; 35(10S):362.
Document Type
Conference Proceeding
Publication Date
10-1-2024
Publication Title
J Am Soc Nephrol
Keywords
adult, African American, aged, apathy, Caucasian, Center for Epidemiological Studies Depression Scale, chronic kidney failure, clinical article, cohort analysis, conference abstract, controlled study, depression, drug therapy, end stage renal disease, female, hemodialysis, high school, human, male, prevalence, racial disparity, therapy
Abstract
Background: African Americans (AAs) have a four-fold higher prevalence of endstage kidney disease (ESKD), high depression risk, and poor adherence to in-center hemodialysis (HD) compared to Whites. Depression and Apathy, and their association with HD adherence, are greatly understudied in AAs. Methods: Validated surveys assessing depressive symptoms (Center for Epidemiologic Studies Depression scale, [range:0-30], higher scores indicating more depressive symptoms) and trait apathy (Apathy Evaluation Scale, [range:7-28], higher scores indicating less apathy), were administered to a multi-site cohort of AAs at 3 HD clinics. Nonadherence was defined as mean proportion of shortened HD sessions (i.e.,>15 minutes less than prescribed HD), and missed HD sessions over the 3-month post-baseline survey period; and mean number of missed/shortened sessions standardized to 36 sessions. Results: AAs (N = 210; mean age 56; 56% male) had been on HD for at least 90 days. About one-third had a high school education or less; earned $10,000 /year or less; and lived alone. Mean number of missed and shortened HD sessions per 36 sessions was 1.8(±3.24) and 3.24(±5.04) respectively. Prevalence of significant depressive symptoms was 29.0%. Higher depressive symptoms (Fig.1) (r= 0.23; p = 0.001) and more apathy (r= -0.15; p = 0.029) correlated with shortened HD but not missed HD sessions. Conclusions: Higher depressive symptoms and more apathy correlated with more shortened sessions in AAs on HD. Motivational strategies to reduce depressive symptoms and apathy, may be a novel way to improve adherence to HD among AAs, curb racial disparities, and promote kidney health equity. (Figure Presented).
Volume
35
Issue
10S
First Page
362
