MENTAL ILLNESS IN PATIENTS WITH KIDNEY FAILURE IN AOTEAROA NEW ZEALAND: A DESCRIPTIVE ANALYSIS
Saiprasad Ravi1, Nicole L De La Mata2, Ben Beaglehole3, Nicholas Cross4, Heather Dunckley5, John Irvine4, Curtis Walker6, Ian Dittmer1, Merryn Jones7, Patrick Kelly2, Kate Wyburn8,9, Angela C Webster2,10,11, 1Auckland City Hospital, Te Whatu Ora Te Toka Tumai Auckland, Auckland, New Zealand2Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia3Department of Psychological Medicine, University of Otago, Christchurch, New Zealand4Department of Nephrology, Te Whatu Ora – Waitaha Canterbury, Christchurch Hospital, New Zealand5New Zealand Transplantation and Immunogenetics Laboratory, New Zealand Blood Service, Auckland, New Zealand6Internal Medicine, Medical Council of New Zealand, Te Whatu Ora Te Pae Hauora o Ruahine o Tararua MidCentral, New Zealand7Kidney Health New Zealand Tākihi Hauora Aotearoa, Christchurch, New Zealand8Renal Unit, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, NSW, Australia9Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia10Centre for Renal and Transplant Research, Westmead Hospital, Sydney, NSW, Australia11NHMRC Clinical Trials Centre, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
Abstract
Aim:
To describe prevalence of mental illness (MI) in the kidney failure (KF) population of Aotearoa New Zealand including pertinent sociodemographic and clinical covariates, and clinical outcomes.
Background:
Comorbid MI in KF patients is common but has not been reported in Aotearoa New Zealand. It is likely burden of MI among the KF population varies by demographics and other social determinants of health.
Methods:
We included adult patients with incident KF between 1st July 2008 and 31st December 2019 using the ASSET linked data platform, including ANZDATA, medications and mental health service utilisation. MI was defined as: a) use of antidepressants or antipsychotics, or b) mental health service use (inpatient, community/residential), occurring on at least two occasions/year. We considered severe MI to be antipsychotic prescription/psychiatric admission.
Results:
Of 6392 patients, 1631 (26%) had MI of which 12% was severe. MI was present prior to onset of KF for 63%. Burden of MI was similar between sexes (26% females, 25% males) but greater in people aged <55 years (53% vs. 34%), and those of European ethnicity (31%, vs. 25% Maori vs. 16% Pasifika). Of patients with MI, 34% were waitlisted for transplant (vs. 22% without MI), and 23% received a transplant (vs. 16% without MI). Mortality was similar in those with and without MI (39% vs 45%).
Conclusion:
MI, mostly pre-existing, affected one in four with KF in Aotearoa New Zealand. In this cohort, incidence of treated MI was similar between sexes, but higher in younger people and in those of European ethnicity. Further research into patient trajectories is needed to understand the impact MI has on access to waitlisting, transplantation and patient outcomes.
Biography
Saiprasad (Prasad) Ravi is an Advanced Trainee in Nephrology and General Medicine. He is currently based in the Renal Unit at Te Toka Tumai Auckland. His interests within Renal medicine are wide-ranging, and include improving equity of care.
Shaun Summers Clinical Trainee Award Presentation PDF Slides