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儿童慢性肾脏病中的抑郁及其相关因素。

Depression and its associated factors in pediatric chronic kidney disease.

机构信息

Division of Pediatric Nephrology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.

出版信息

Pediatr Nephrol. 2013 Sep;28(9):1855-61. doi: 10.1007/s00467-013-2497-5. Epub 2013 May 23.

Abstract

BACKGROUND

Few studies on the occurrence of depression in pediatric patients with chronic kidney disease (CKD) have been conducted and none have identified associated clinical and demographic factors.

METHODS

This was a cross-sectional study in which we administered the Child Depression Inventory-2 (CDI-2) to 44 patients aged 9-18 years with CKD stages III-V. Criteria for depression were CDI-2 scores of ≥65 or an established diagnosis of depression recorded in the medical chart. Relative risks (RR) and 95 % confidence intervals (CI) were calculated to determine associations between patient characteristics and depression status.

RESULTS

Of the 44 patients enrolled in the study, 13 (30 %) met our criteria for depression, representing 18 % of patients aged <13 years and 34 % of those aged ≥13 years. Although not reaching statistical significance, the adjusted risk of depression was lower for patients with CKD duration of ≤3 years than for those with longer CKD duration (RR 0.19, 95 % CI 0.02, 1.53), and for those with CKD stage IV (RR 0.23, 95 % CI 0.05, 1.09) and CKD stage V (RR 0.13, 95 % CI 0.01, 1.07) compared to those with CKD stage III.

CONCLUSIONS

Our results indicate that depression is common in children with CKD, particularly for those with longstanding renal disease and at CKD stage III.

摘要

背景

针对儿科慢性肾脏病(CKD)患者抑郁发生情况开展的研究较少,且尚未确定相关的临床和人口统计学因素。

方法

这是一项横断面研究,我们对 44 名年龄为 9-18 岁、CKD 分期为 III-V 期的患者进行了儿童抑郁量表-2(CDI-2)测试。抑郁的标准为 CDI-2 评分≥65 分,或病历中记录有明确的抑郁诊断。计算相对风险(RR)和 95%置信区间(CI)以确定患者特征与抑郁状态之间的关联。

结果

在纳入研究的 44 名患者中,有 13 名(30%)符合我们的抑郁标准,这代表着 18%的<13 岁患者和 34%的≥13 岁患者患有抑郁。尽管未达到统计学意义,但与 CKD 病程>3 年的患者相比,病程≤3 年的患者抑郁风险较低(RR 0.19,95%CI 0.02,1.53),与 CKD 分期 IV(RR 0.23,95%CI 0.05,1.09)和 CKD 分期 V(RR 0.13,95%CI 0.01,1.07)的患者相比,CKD 分期 III 的患者抑郁风险较低。

结论

我们的研究结果表明,CKD 患儿中抑郁较为常见,尤其是那些患有慢性肾病时间较长和 CKD 分期较高的患儿。

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本文引用的文献

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Depression in adolescents with chronic medical illness.
Int J Adolesc Med Health. 2011;23(3):205-8. doi: 10.1515/ijamh.2011.045.
7
Prevalence of major depressive episode in CKD.慢性肾脏病中重度抑郁发作的患病率。
Am J Kidney Dis. 2009 Sep;54(3):424-32. doi: 10.1053/j.ajkd.2009.03.017. Epub 2009 Jun 3.
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New equations to estimate GFR in children with CKD.估算慢性肾脏病儿童肾小球滤过率的新方程。
J Am Soc Nephrol. 2009 Mar;20(3):629-37. doi: 10.1681/ASN.2008030287. Epub 2009 Jan 21.
9
Psychological profile of adolescents with a kidney transplant.
Pediatr Transplant. 2009 Sep;13(6):701-10. doi: 10.1111/j.1399-3046.2008.01053.x. Epub 2008 Oct 7.

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