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Abstract: SA-PO1102

Depressive Symptoms Do Not Worsen over Time in Individuals with CKD: The BRINK Study

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Knapp, Christopher D., Hennepin Healthcare System Inc, Minneapolis, Minnesota, United States
  • Gao, Allan Y., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
  • Roetker, Nicholas S., Hennepin Healthcare System Inc, Minneapolis, Minnesota, United States
  • Horak, Kayla L., Hennepin Healthcare System Inc, Minneapolis, Minnesota, United States
  • Farnum, Ashley, Hennepin Healthcare System Inc, Minneapolis, Minnesota, United States
  • Hart, Allyson, Hennepin Healthcare System Inc, Minneapolis, Minnesota, United States
  • Johansen, Kirsten L., Hennepin Healthcare System Inc, Minneapolis, Minnesota, United States
  • Murray, Anne M., Hennepin Healthcare System Inc, Minneapolis, Minnesota, United States
Background

The prevalence of depression is high in the chronic kidney disease (CKD) (20-40%) and dialysis (30-50%) populations. It is unclear how depression symptoms change over time in patients with CKD.

Methods

Participants in the Brain in Kidney Disease (BRINK) cohort completed a Patient Health Questionnaire (PHQ-9) and an eGFR annually. We completed a retrospective longitudinal analysis of this cohort using a mixed linear effects model to examine the mean change in PHQ-9 score by CKD stage compared with the changes among people without CKD. We also compared changes in depression scores among those who initiated dialysis and those with CKD5.

Results

We followed 571 participants for up to five years, of whom 31% reported a diagnosis of depression at baseline. Baseline PHQ-9 scores were 3.5, 4.4, 4.3, 4.7, and 4.8 for participants without CKD (n=147) and those with CKD3a (n=98), 3b (n=190), 4 (n=112), and 5 (n=24), respectively. After adjustment for baseline PHQ-9 score and covariates, mean PHQ-9 scores improved by 0.20 points per year (95% confidence interval [CI] 0.08-0.33) for people who remained without CKD, and improved by 0.30 points (95% CI 0.14-0.47) and 0.19 points (95% CI 0.07-0.32) for people with CKD 3a and 3b (figure), while annual mean PHQ-9 scores among patients with CKD 4 or 5 and dialysis-dependent CKD did not change significantly. Compared with participants who did not develop CKD, no differences in changes in PHQ-9 scores for any CKD subgroup were observed, nor when comparing change in PHQ-9 scores between people with dialysis-dependent CKD and CKD 5. Results were similar in a sensitivity analysis that excluded 141 individuals reporting anti-depressant use.

Conclusion

We found that mean PHQ-9 scores improved slightly over time in people without CKD and those with stage 3 CKD, but not among those with later stage CKD. However, when we directly compared changes in PHQ-9 scores between those with any stage of CKD and those without CKD, we did not observe significant differences. Our study suggests that progression of CKD may not result in worsening depressive symptoms.

Funding

  • Other NIH Support