Adults who have normal kidney function but who also battle depression are more likely to experience kidney function decline, a new study has found. The study also revealed that depression may contribute to faster kidney function decline in patients living with chronic kidney disease (CKD). 

CKD is “a leading risk factor for cardiovascular disease, kidney failure, and mortality worldwide,” said lead investigator Xianhui Qin, MD, from Nanfang Hospital, Southern Medical University, China. “The identification of more modifiable risk factors may possibly reduce the huge burden of CKD and its related complications by leading to early detection and prevention.”

What They Did

The study involved 4,763 people (average age 59 years) with healthy kidneys, indicated by an estimated glomerular filtration rate (eGFR) of > 60. All participants were enrolled from the China Health and Retirement Longitudinal Study, and 39% of them had severe symptoms of depression at baseline, indicated by a Center for Epidemiologic Studies Depression (CES-D) score of ≥10. The researchers’ outcome of interest was a rapid decline in kidney function, defined as:

• An annual eGFR decline of >5 mL/min (primary outcome) 
• An annual eGFR decline of > 5 mL/min to <60 mL/min (secondary outcome)

What They Found

After adjusting for such factors as demographic, clinical, and psychosocial characteristics, a significant positive association was found between baseline depression symptoms and rapid decline in kidney function. Overall, during an average follow-up of four years:

• Approximately 6% of participants experienced rapid decline in kidney function 
• A 24% greater chance of rapid kidney decline was found among those with moderate depressive symptoms (CES-D score 10 to <21) vs low symptoms (CES-D score <10)
• A 118% greater chance of rapid kidney decline was found among those with higher depressive symptoms (CES-D score >21) depressive symptoms, respectively, vs low (total CES-D score, < 10)

What it Means

“While our study does not show causality, it demonstrated that high depressive symptoms were significantly associated with rapid decline in kidney function among Chinese adults with normal kidney function,” said Qin. 

“If further confirmed, our data provide some evidence for depressive symptom screening and effective psychosocial interventions to improve the prevention of CKD.”

*Loder, S. (2021, June 21). Potential Link Found Between Depression, Kidney Failure. American Journal of Managed Care. https://www.ajmc.com/view/potential-link-found-between-depression-kidney-failure