Publications [#277751] of Sherman A. James

Journal Articles

1. Lopes, GB; Matos, CM; Leite, EB; Martins, MTS; Martins, MS; Silva, LF; Robinson, BM; Port, FK; James, SA; Lopes, AA, Depression as a potential explanation for gender differences in health-related quality of life among patients on maintenance hemodialysis., Nephron. Clinical practice, vol. 115 no. 1 (January, 2010), pp. c35-c40, ISSN 1660-2110 [doi]
   (last updated on 2024/04/24)

   Abstract:
   

   Background/aims

   The reasons for lower health-related quality of life (HRQOL) scores in women compared to men on maintenance hemodialysis (MHD) are unknown. We investigated whether depression accounts for gender differences in HRQOL.

   Methods

   Cross-sectional study of 868 (40.9% women) Brazilian MHD patients (PROHEMO Study). We used the Kidney Disease Quality of Life Short Form to assess HRQOL and the Center for Epidemiological Studies Depression (CES-D) scale (scores from 0-60) to assess depression with scores >or=18 indicating high depression probability.

   Results

   Higher depression scores were associated with lower HRQOL in both sexes. Women had higher depression scores; 51.8% of women versus 38.2% of men (p < 0.001) had CES-D scores >or=18. Women scored lower on all 9 assessed HRQOL scales. The female-to-male differences in HRQOL were slightly reduced with inclusion of Kt/V and comorbidities in regression models. Substantial additional reductions in female-to-male differences in all HRQOL scales were observed after including depression scores in the models, by 50.9% for symptoms/problems related to renal failure, by 71.6% for mental health and by 87.1% for energy/vitality.

   Conclusions

   Lower HRQOL among women was largely explained by depression symptoms. Results support greater emphasis on treating depression to improve HRQOL in MHD patients, particularly women.