The prevalence of depression and the association between depression and kidney function and health-related quality of life in elderly patients with chronic kidney disease: a multicenter cross-sectional study
Received 2 February 2019
Accepted for publication 4 April 2019
Published 15 May 2019 Volume 2019:14 Pages 905—913
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Zhi-Ying Wu
Wen-Ling Wang,1,2 Shuang Liang,1 Fang-Lei Zhu,1 Jie-Qiong Liu,1 Si-Yang Wang,1 Xiang-Mei Chen,1 Guang-Yan Cai1
On behalf of the C-OPTION study group
1Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease, Beijing, People’s Republic of China; 2General Internal Medicine Department, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China
Purpose: The prevalence of depression and the relationship between depression and kidney function and health-related quality of life (HRQOL) are not well understood in elderly patients with predialysis chronic kidney disease (CKD). This study aimed to evaluate the prevalence of depression and the association between depression and kidney function and HRQOL.
Patients and methods: In this cross-sectional study, 1079 elderly participants with CKD were recruited at 32 clinical centers located within 26 cities throughout 24 provinces in China. Demographic information and laboratory analyses were collected. Symptoms of depression were assessed using the 15-item Geriatric Depression Scale (GDS-15). HRQOL was evaluated using the Kidney Disease Quality of Life-36 (KDQOL-36) instrument.
Results: The prevalence of depression was 23.0%. The estimated glomerular filtration rate (eGFR) was negatively correlated with the GDS score whether it was treated as a categorical variable (r=−0.097, P=0.001) or as a continuous variable (r=−0.100, P=0.001). Marital status, education level, history of CVD and diabetes, CKD stage and proteinuria confirmed to be independent and significant predictors of depression in patients with CKD. Compared with CKD 1–2 patients, we observed an increase of 0.541 and 4.171 in the odds for developing depression in patients CKD 4 (odds ratio [OR] =1.541; P=0.031) and CKD 5 (odds ratio [OR] =5.171; P<0.001), respectively. We observed negative and significant correlations with the GDS score for the following components: PCS (r=−0.370, P<0.001), MCS (r=−0.412, P<0.001), burden of kidney disease (r=−0.403, P<0.001), symptoms and problems of kidney disease (r=−0.360, P<0.001) and effects of kidney disease (r=−0.355, P<0.001). Depression was an independent and significant predictor of all the subcomponents of the HRQOL.
Conclusions: The prevalence of depression in elderly patients with CKD was high and was negatively correlated with kidney function. Depression had a major negative impact on HRQOL.
Keywords: chronic kidney disease, health-related quality of life, depression, aging, kidney function