Veterans With PTSD Less Likely to Die After Starting Dialysis

NEW ORLEANS—US veterans with post-traumatic stress disorder (PTSD) have a lower death risk following dialysis initiation, researchers reported at Kidney Week 2017.

Vanessa Ravel, MPH, of the University of California Irvine, and colleagues examined hospitalization and all-cause mortality rates for 79,331 veterans (mean age 71 years) with end-stage renal disease starting dialysis during 2007 to 2014. Of these, 5464 (6.9%) had a history of PTSD.

Patients with PTSD had 11% lower risk for death from any cause 1 year after starting dialysis than those without the psychiatric disorder, but PTSD patients were 5% more likely to be hospitalized during the same period.

Increased hospitalization might have led to receipt of more health care and better survival, the investigators posited. Alternately, psychosocial factors might have influenced wellbeing. Just 5% of veterans were women, 24% were black, and 9% were homeless. Models were adjusted for demographics, comorbidities, and markers of malnutrition and inflammation.

“Providing optimal health care, including mental health care, is of the utmost importance in improving survival in veterans with end stage renal disease,” co-investigator Elani Streja, MD, told Renal & Urology News. “More research is needed to understand the underlying causes of the findings, and whether results relate to particular physiological or psychosocial factors or better utilization of health services. We plan to do further analyses investigating the association of PTSD and health-related outcomes in renal disease patients.”

Ravel VA, Streja E, Rhee C, Kovesdy CP, Kalantar-Zadeh K. Posttraumatic stress disorder and outcomes among US veterans who transition to renal replacement therapy: A transition of care in CKD study. Presented in poster format at Kidney Week 2017 in New Orleans (Oct. 31 to Nov. 5). Abstract SA-PO454.