Depression, Quantified Medication Adherence, and Quality of Life in Renal Transplant Candidates and Recipients

J Clin Psychol Med Settings. 2022 Mar;29(1):168-184. doi: 10.1007/s10880-021-09792-2. Epub 2021 Jun 4.

Abstract

Like patients with many chronic illnesses, ESRD patients experience psychological challenges with greater incidence of depression and reduced quality of life (QoL). A series of 139 transplant candidates' depression and QoL, and a subset of 82 candidates' medication adherence were monitored, revealing heterogenous patterns of depression and adherence and reduced QoL. Twenty-eight patients who received kidney transplants were re-evaluated 6 months post-transplant revealing mixed patterns. Mean depression and quantitated adherence decreased and QoL increased. Some patients improved whereas others declined in depression and adherence. Pre-transplant depression was negatively correlated with post-transplant adherence but positively correlated with post-transplant depression. Nevertheless, the ability to predict individuals' post-transplant adherence and depression, principal objectives of pre-transplant psychological evaluations, is limited. Consequently, it is important to provide periodic screening of ESRD patients for depression and adherence pre- and post-transplant as they reflect changing states, rather than static traits, with variable patterns across patients.

Keywords: Adherence; Depression; ESRD; Medication; Transplantation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Depression / epidemiology
  • Depression / psychology
  • Female
  • Humans
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / epidemiology
  • Kidney Failure, Chronic* / surgery
  • Kidney Transplantation* / psychology
  • Male
  • Medication Adherence / psychology
  • Quality of Life / psychology