A Preliminary Investigation of Depression and Kidney Functioning in Patients with Chronic Kidney Disease
A Preliminary Investigation of Depression and Kidney Functioning in Patients with Chronic Kidney Disease
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DOI：
10.1159/000349940
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发表时间：
2012-01-01
影响因子：
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通讯作者：
Saggi, Subodh J.
中科院分区：
文献类型：
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作者：
Cukor, Daniel;Fruchter, Yvette;Saggi, Subodh J.
背景：慢性肾脏病（CKD）的发病率和患病率正在迅速增长。了解肾功能下降的相关因素具有重要的临床意义。本研究的主要目的是确定可以预测不同阶段CKD门诊患者肾小球滤过率（GFR）随时间下降的变量。方法：对70例CKD患者进行心理问卷调查，并从病历中提取医学变量。6个月后收集随访GFR。将抑郁评分升高的CKD患者与亚临床抑郁患者的医疗和心理变量进行比较。结果：平均贝克抑郁量表（BDI）评分为10.0 +/- 7.8，平均值低于临床升高的临界值。两组的GFR有显著性差异（非抑郁组为40.0 ± 11.3，抑郁组为29.6 ± 8.9; p < 0.05）。同样，抑郁评分升高的患者报告生活质量较低（简明健康调查表36; p < 0.05），社会支持较差（人际支持评估表; p < 0.05），社区融合较差（社区融合问卷; p < 0.05）。利用回归，用校正基线GFR的模型，BDI解释了GFR降低受试者GFR评分19%的方差（t =-2.0，p < 0.05）。结论：先前存在的抑郁水平的增加与生活质量、社会支持和肾功能低下有关。抑郁评分解释了6个月时GFR评分的显著差异，即使校正了基线变异性。抑郁评分升高在CKD人群中普遍存在，需要进一步研究抑郁干预的影响。版权所有（c）2013 S. Karger AG，巴塞尔
Background: The incidence and prevalence of Chronic Kidney Disease (CKD) is growing rapidly. Understanding the factors associated with declining renal function is of clinical significance. The current study's main goal was to identify variables that could predict decline in glomerular filtration rate (GFR) over time in outpatients with varying stages of CKD. Methods: Seventy CKD patients completed psychological questionnaires and medical variables were extracted from the medical charts. Follow-up GFR was collected 6 months later. CKD patients with elevated depression scores were compared to patients with subclinical depression on medical and psychological variables. Results: Average Beck Depression Inventory (BDI) score was 10.0 +/- 7.8, placing the mean below the cut-off for clinical elevation. GFR was significantly different for the two groups (nondepressed, 40.0 +/- 11.3 vs. depressed 29.6 +/- 8.9; p < 0.05). Similarly, patients with elevated depression scores reported lower quality of life (Short Form 36 Health Survey; p < 0.05) inferior social support (Interpersonal Support Evaluation List; p < 0.05), and worse community integration (Community Integration Questionnaire; p < 0.05). Utilizing a regression, with a model correcting for baseline GFR, the BDI explained 19% of the variance in GFR score (t = -2.0, p < 0.05) for subjects with decreased GFR. Conclusions: Increased levels of preexisting depression were associated with inferior quality of life, social support and kidney functioning. Depression scores explained a significant amount of variance in GFR scores at 6 months even when corrected for baseline variability. Elevated depression scores are prevalent in CKD populations and further research on the impact of depression interventions is warranted. Copyright (c) 2013 S. Karger AG, Basel