Cheng Xi, Cai Xiting, Ma Jinzhao, Feng Yuming, Zou Zhichuan, Wang Wenhua, Chen Li, Yao Bing
Center of Reproductive Medicine, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University. No.305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu, China.
Clin Exp Nephrol. 2025 Aug 18. doi: 10.1007/s10157-025-02732-6.
BACKGROUND: There was a link between depression and chronic kidney disease (CKD), yet causal relationship between them remains underexplored. This study was conducted to explore this relationship and offer fresh perspectives on how CKD affected depression risk. METHODS: Initially, 7537 subjects from National Health and Nutrition Examination Survey (NHANES) were categorized into depression and control groups based on Patient Health Questionnaire 9 (PHQ-9). Afterwards, the baseline characteristics and risk association analyses (weighted multivariate/stratified logistic regression analyses) were applied to evaluate associations of CKD and various covariates with depression. The predictive ability of CKD for depression risk was assessed by receiver operating characteristic (ROC) analysis. Eventually, the relationship between CKD and depression was further corroborated by Mendelian randomization (MR) analysis. RESULTS: In addition to CKD, eight covariates like age and gender demonstrated significant associations with depression, with marked differences exhibited between depression (n = 365) and control (n = 3373) groups. Notably, CKD emerged as a risk factor for depression across three logistic regression models (OR > 1, 95% CI ≠ 1, p < 0.05). The association between CKD and depression was robust and stable, minimally influenced by covariates. Additionally, an area under curve (AUC) of 0.818 demonstrated significant predictive effectiveness of CKD as a risk factor for depression. Eventually, a positive causal relationship between CKD and depression was confirmed by MR analysis (OR = 1.002, 95% CI = 1.000-1.003, p < 0.05). CONCLUSION: CKD could increase the risk of depression, underscoring the need for targeted interventions to mitigate this risk.
背景:抑郁症与慢性肾脏病(CKD)之间存在关联,但二者之间的因果关系仍未得到充分探索。本研究旨在探讨这种关系,并就CKD如何影响抑郁症风险提供新的视角。 方法:最初,根据患者健康问卷9(PHQ-9)将来自美国国家健康与营养检查调查(NHANES)的7537名受试者分为抑郁症组和对照组。之后,应用基线特征和风险关联分析(加权多变量/分层逻辑回归分析)来评估CKD及各种协变量与抑郁症的关联。通过受试者工作特征(ROC)分析评估CKD对抑郁症风险的预测能力。最终,通过孟德尔随机化(MR)分析进一步证实CKD与抑郁症之间的关系。 结果:除CKD外,年龄和性别等八个协变量与抑郁症表现出显著关联,抑郁症组(n = 365)和对照组(n = 3373)之间存在明显差异。值得注意的是,在三个逻辑回归模型中,CKD均成为抑郁症的一个风险因素(OR > 1,95% CI ≠ 1,p < 0.05)。CKD与抑郁症之间的关联稳健且稳定,受协变量的影响最小。此外,曲线下面积(AUC)为0.818,表明CKD作为抑郁症风险因素具有显著的预测效力。最终,MR分析证实了CKD与抑郁症之间存在正向因果关系(OR = 1.002,95% CI = 1.000 - 1.003,p < 0.05)。 结论:CKD会增加患抑郁症的风险,这凸显了采取针对性干预措施以降低这种风险的必要性。
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2025-5
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