Published in:
Open Access 01-12-2022 | Affective Disorder | Research
The synergistic effect of depression and moderate chronic kidney disease on the all-cause and cardiovascular disease mortality among adults: a retrospective cohort study
Published in: BMC Nephrology | Issue 1/2022
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Background
The relationship between the coexistence of depression and moderate chronic kidney disease (CKD) and mortality is unclear. We aimed to investigate whether there is a synergistic effect of depression and moderate CKD on the all-cause and cardiovascular disease (CVD) mortality among adults.
Methods
We studied 24,412 participants from the National Health and Nutrition Examination Survey 2005–2014 with a mortality follow-up assessment in 2015. Four groups were created based on depression and CKD status: Group 1, no depression and no CKD; Group 2, depression present and no CKD; Group 3: no depression and CKD present; Group 4: depression present and CKD present. Moderate CKD was defined as an estimated glomerular filtration rate of 15–59 mL/min/1.73 m2 (Stage 3–4) or one-time urine albumin-to-creatinine ratio ≥ 30 mg/g. Depression was defined as the 9-item Patient Health Questionnaire score of 10 or more. Cox proportional hazards regression models were used to calculate the multivariate-adjusted hazard ratios (HRs) of death for Group 4 with other groups.
Results
Over a mean follow-up of 5.8 years, 1783 deaths were documented, including 338 deaths from CVD. The HR for all-cause mortality in Group 4 was 3.62 (95% CI: 2.69–4.87), 2.99 (1.92–4.66), and 1.75 (1.29–2.37) when compared with Group 1, 2, and 3, respectively. The HR for CVD mortality in Group 4 was 3.89 (1.68–9.00), 1.90 (0.86–4.21), and 1.97 (1.17–3.32) when compared with Group 1, 2, and 3, respectively.
Conclusions
There might be a synergistic effect of depression and moderate CKD on all-cause mortality. Moreover, depression might increase the risk of CVD mortality in individuals with moderate CKD.