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
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
