{"doi":"10.1016/j.ekir.2022.04.015","title":"Overcoming the Blues: Can Managing Depressive Symptoms Improve Access to Kidney Transplantation?","abstract":"See Clinical Research on Page 1306 See Clinical Research on Page 1306 Lack of access to kidney transplantation—the preferred treatment for most patients with end-stage kidney disease (ESKD), in terms of costs, health-related quality of life, and clinical outcomes—remains an issue worldwide. In the United States, fewer than one-third of patients with prevalent ESKD had a functioning graft in 2019 and only 3% of patients with ESKD had a pre-emptive kidney transplant.1National Institute of Diabetes and Digestive and Kidney Diseases2021 USRDS Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. United States Renal Data System. National Institutes of Health, Bethesda, MD2021Google Scholar Disparities in kidney transplant access by age and race/ethnicity are also prominent in the United States: for example, 14%, 11%, and 7% of White, Black, and Native American patients with ESKD being waitlisted or transplanted within 1 year of diagnosis, and adults aged 18 to 44 years are twice as likely to be waitlisted or transplanted within a year as those aged 65 to 74 years (14% vs. 7%).1National Institute of Diabetes and Digestive and Kidney Diseases2021 USRDS Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. United States Renal Data System. National Institutes of Health, Bethesda, MD2021Google Scholar Importantly, most of the disparities in access may occur at earlier, prewaitlisting steps in the transplantation process (e.g., transplant evaluation). Obtaining a kidney transplant is a complex and time-intensive process, requiring patients to complete a battery of medical tests and appointments. Multiple barriers to completing the kidney transplantation process have been identified2Harding J.L. Perez A. Patzer R.E. Nonmedical barriers to early steps in kidney transplantation among underrepresented groups in the United States.Curr Opin Organ Transplant. 2021; 26: 501-507https://doi.org/10.1097/MOT.0000000000000903Crossref PubMed Scopus (6) Google Scholar and may include undiagnosed and untreated depressive symptoms among patients presenting for evaluation. To explore this, Chen et al.3Chen X. Chu N.M. Basyal P.S. et al.Depressive symptoms at kidney transplant evaluation and access to the kidney transplant waitlist.Kidney Int Rep. 2022; 7: 1306-1317https://doi.org/10.1016/j.ekir.2022.03.008Abstract Full Text Full Text PDF Scopus (1) Google Scholar administered the Center for Epidemiologic Studies—Depression scale to a cohort of 3879 patients being evaluated for kidney transplantation at a single US center in the course of 11 years (January 2009–March 2020). The authors found that depressive symptoms were highly prevalent (86% reporting any symptoms; minimal, mild, moderate, and severe symptoms were reported by 67%, 7%, 5%, and 7% of patients, respectively). Younger, male, and Black patients were less likely to report depressive symptoms, compared with their counterparts. Those with at least minimal symptoms were 25% less likely to be transplanted or waitlisted within a year of evaluation, independent of several sociodemographic and clinical factors and despite the Center for Epidemiologic Studies—Depression results collected in the study not being considered during the clinical evaluation of the patients.3Chen X. Chu N.M. Basyal P.S. et al.Depressive symptoms at kidney transplant evaluation and access to the kidney transplant waitlist.Kidney Int Rep. 2022; 7: 1306-1317https://doi.org/10.1016/j.ekir.2022.03.008Abstract Full Text Full Text PDF Scopus (1) Google Scholar These novel results suggest that depressive symptoms among patients with ESKD presenting for evaluation can adversely affect subsequent transplant access. This potential effect is likely through 2 main pathways. First, providers may be less likely to place candidates with depressive symptoms on the waitlist after evaluation (Figure 1). Even without a formal assessment, it is likely ","journal":"Kidney International Reports","year":2022,"id":306997,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9497,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1001311,"name":"Krishnam Raju Penmatsa","orcid":"0000-0002-3353-416X","position":1,"is_corresponding":false},{"id":872537,"name":"Megan Urbanski","orcid":"0000-0001-5054-0716","position":2,"is_corresponding":false},{"id":282764,"name":"Laura Plantinga","orcid":"0000-0003-0809-8981","position":0,"is_corresponding":true}],"reference_count":7,"raw_metadata":null,"created_at":"2026-07-19T00:32:52.703737Z","pmid":"35694564","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}