Kidney Week

Abstract: TH-PO858

Apathy, Depression, and Hemodialysis Adherence in African American Patients

Session Information

• Race, Ethnicity, and Gender in Kidney Health and Care
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diversity and Equity in Kidney Health

• 900 Diversity and Equity in Kidney Health

Authors

• Roche, Meaghan Sarah, Henry Ford Health System, Detroit, Michigan, United States

Meaghan Sarah Roche, MD

• Wild, Marcus G., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Marcus G. Wild, PhD

• Mahfouz, Ratib Talal, Henry Ford Health System, Detroit, Michigan, United States

Ratib Talal Mahfouz, MD

• Rajagopal, Amulya, Henry Ford Health System, Detroit, Michigan, United States

Amulya Rajagopal, MD

• Osorio, Luis G., Henry Ford Health System, Detroit, Michigan, United States

Luis G. Osorio, DO

• Najjar Mojarrab, Javad, Henry Ford Health System, Detroit, Michigan, United States

Javad Najjar Mojarrab, MD, MBA

• Henry-Okafor, Queen, Vanderbilt University School of Nursing, Nashville, Tennessee, United States

Queen Henry-Okafor, PhD, APRN, FNP

• Liddell, Toddra, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Toddra Liddell, APRN

• Fissell, Rachel B., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Rachel B. Fissell, MD, MS

• Nair, Devika, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Devika Nair, MD, MS, FASN

• Prigmore, Heather Leanne, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Heather Leanne Prigmore, MPH

• Greevy, Robert, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Robert Greevy, PhD

• Cavanaugh, Kerri L., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Kerri L. Cavanaugh, MD, MHS, FASN

• Tindle, Hilary A., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Hilary A. Tindle, MD, MPH

• Umeukeje, Ebele M., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Ebele M. Umeukeje, MD, MPH, FASN

Background

African Americans (AAs) have a four-fold higher prevalence of end-stage 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.

Conclusion

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.

Funding

• NIDDK Support