Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Disease, Beijing, People's Republic of China.
General Internal Medicine Department, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China.
Clin Interv Aging. 2019 May 15;14:905-913. doi: 10.2147/CIA.S203186. eCollection 2019.
The prevalence of depression and the relationship between depression and kidney function and health-related quality of life (HRQOL) are not well understood in elderly patients with predialysis chronic kidney disease (CKD). This study aimed to evaluate the prevalence of depression and the association between depression and kidney function and HRQOL. In this cross-sectional study, 1079 elderly participants with CKD were recruited at 32 clinical centers located within 26 cities throughout 24 provinces in China. Demographic information and laboratory analyses were collected. Symptoms of depression were assessed using the 15-item Geriatric Depression Scale (GDS-15). HRQOL was evaluated using the Kidney Disease Quality of Life-36 (KDQOL-36) instrument. The prevalence of depression was 23.0%. The estimated glomerular filtration rate (eGFR) was negatively correlated with the GDS score whether it was treated as a categorical variable (r=-0.097, =0.001) or as a continuous variable (r=-0.100, =0.001). Marital status, education level, history of CVD and diabetes, CKD stage and proteinuria confirmed to be independent and significant predictors of depression in patients with CKD. Compared with CKD 1-2 patients, we observed an increase of 0.541 and 4.171 in the odds for developing depression in patients CKD 4 (odds ratio [OR] =1.541; =0.031) and CKD 5 (odds ratio [OR] =5.171; <0.001), respectively. We observed negative and significant correlations with the GDS score for the following components: PCS (r=-0.370, <0.001), MCS (r=-0.412, <0.001), burden of kidney disease (r=-0.403, <0.001), symptoms and problems of kidney disease (r=-0.360, <0.001) and effects of kidney disease (r=-0.355, <0.001). Depression was an independent and significant predictor of all the subcomponents of the HRQOL. The prevalence of depression in elderly patients with CKD was high and was negatively correlated with kidney function. Depression had a major negative impact on HRQOL.
在中国 24 个省的 26 个城市的 32 个临床中心，招募了 1079 名患有透析前慢性肾脏病（CKD）的老年患者，进行了这项横断面研究。收集了人口统计学信息和实验室分析。使用 15 项老年抑郁量表（GDS-15）评估抑郁症状。使用肾脏病生活质量-36（KDQOL-36）量表评估 HRQOL。
抑郁的患病率为 23.0%。估算肾小球滤过率（eGFR）与 GDS 评分呈负相关，无论其作为分类变量（r=-0.097，=0.001）还是作为连续变量（r=-0.100，=0.001）。婚姻状况、受教育程度、CVD 和糖尿病史、CKD 分期和蛋白尿被证实是 CKD 患者抑郁的独立和重要预测因素。与 CKD 1-2 期患者相比，我们观察到 CKD 4 期（比值比[OR]=1.541；=0.031）和 CKD 5 期（OR=5.171；<0.001）患者发生抑郁的几率分别增加了 0.541 和 4.171。我们观察到 GDS 评分与以下各组成部分呈负相关和显著相关：PCS（r=-0.370，<0.001）、MCS（r=-0.412，<0.001）、肾脏疾病负担（r=-0.403，<0.001）、肾脏疾病症状和问题（r=-0.360，<0.001）和肾脏疾病的影响（r=-0.355，<0.001）。抑郁是 HRQOL 所有亚成分的独立和重要预测因素。
CKD 老年患者的抑郁患病率较高，与肾功能呈负相关。抑郁对 HRQOL 有重大负面影响。
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