Abstract
Aim: To describe prevalence of mental illness (MI) in the kidney failure(KF) population of Aotearoa New Zealand including pertinent socio-demographic 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 1 July2008 and 31 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 MI16 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 wait listing, transplantation and patient outcomes.