Depression, Stress, and Quality of Life in Persons with Chronic Kidney Disease: the Heart and Soul Study

Overview

Journal Nephron Clin Pract

Publisher Karger

Specialty Nephrology

Date 2005 Dec 13

PMID 16340237

Citations 26

Authors

Michelle C Odden

Mary A Whooley

Michael G Shlipak

Affiliations

Soon will be listed here.

Abstract

Background: The effect of mild chronic kidney disease (CKD) on depression, stress, quality of life (QOL), and health status is not well understood. We compared these outcomes in subjects with and without CKD.

Methods: We performed a cross-sectional study of 967 outpatients enrolled in the Heart and Soul Study. CKD was defined as a measured creatinine clearance < 60 ml/min. Outcome measures included depressive symptoms measured using the Patient Health Questionnaire (PHQ), stress measured using the Perceived Stress Scale (PSS), and QOL and overall health rated as excellent, very good, good, fair, or poor.

Results: The prevalence of depressive symptoms (17 vs. 19%, p = 0.4) or perceived stress (11 vs. 16%, p = 0.09) did not vary significantly by CKD. The prevalence of fair or poor QOL was not significantly different in subjects with CKD, compared with those without CKD (24 vs. 23%, p = 0.65). Age-adjusted analyses revealed a significant association of CKD with QOL (p = 0.003), however, this association no longer reached statistical significance after adjustment for confounders (p = 0.06). Subjects with CKD were more likely to report poor or fair overall health than subjects without CKD (42 vs. 34%, p = 0.03). After multivariate adjustment, CKD remained significantly associated with worse overall health (OR = 1.65, 95% CI 1.21-2.24, p = 0.001), and modestly associated with QOL (OR = 1.31, 95% CI 0.99-1.75, p = 0.06), but had no association with depression (p = 0.48) or stress (p = 0.24).

Conclusion: In this study of persons with coronary artery disease, subjects with CKD had reduced overall health and modestly reduced QOL; however, mental health was similar in those with and without CKD. These findings suggest that self- assessed overall health may decline at earlier stages of renal dysfunction than mental health outcomes or QOL.

Citing Articles

Depression among patients with chronic kidney disease, associated factors, and predictors: a cross-sectional study.

Bahall M, Legall G, Lalla C BMC Psychiatry. 2023; 23(1):733.

PMID: 37817099 PMC: 10566121. DOI: 10.1186/s12888-023-05249-y.

Rapid decline in kidney function is associated with rapid deterioration of health-related quality of life in chronic kidney disease.

Kim H, Kim D, Rhee H, Song S, Park S, Kim S Sci Rep. 2023; 13(1):1786.

PMID: 36720969 PMC: 9889397. DOI: 10.1038/s41598-023-28150-w.

Depression and chronic kidney disease: a cross-sectional study based at Bugando Medical Centre, Northwestern Tanzania.

Munisi H, Sylvester I, Mwakalebela I, Kanenda S, Rudovick L, Mwita M Pan Afr Med J. 2022; 42:297.

PMID: 36415338 PMC: 9643796. DOI: 10.11604/pamj.2022.42.297.31414.

Patient-reported outcomes in a pilot clinical trial of twice-weekly hemodialysis start with adjuvant pharmacotherapy and transition to thrice-weekly hemodialysis vs conventional hemodialysis.

Murea M, Highland B, Yang W, Dressler E, Russell G BMC Nephrol. 2022; 23(1):322.

PMID: 36167537 PMC: 9513956. DOI: 10.1186/s12882-022-02946-w.

Faulhaber L, Herget-Rosenthal S, Jacobs H, Hoffmann F Kidney Blood Press Res. 2021; 47(1):13-22.

PMID: 34818245 PMC: 8820424. DOI: 10.1159/000518668.

References

Kimmel P, Peterson R, Weihs K, Simmens S, Alleyne S, Cruz I . Multiple measurements of depression predict mortality in a longitudinal study of chronic hemodialysis outpatients. Kidney Int. 2000; 57(5):2093-8. DOI: 10.1046/j.1523-1755.2000.00059.x. View

Kimmel P . Psychosocial factors in adult end-stage renal disease patients treated with hemodialysis: correlates and outcomes. Am J Kidney Dis. 2000; 35(4 Suppl 1):S132-40. DOI: 10.1016/s0272-6386(00)70240-x. View

Finkelstein F, Finkelstein S . Depression in chronic dialysis patients: assessment and treatment. Nephrol Dial Transplant. 2000; 15(12):1911-3. DOI: 10.1093/ndt/15.12.1911. View

. IV. NKF-K/DOQI Clinical Practice Guidelines for Anemia of Chronic Kidney Disease: update 2000. Am J Kidney Dis. 2001; 37(1 Suppl 1):S182-238. DOI: 10.1016/s0272-6386(01)70008-x. View

Bernhard J, Sullivan M, Hurny C, Coates A, RUDENSTAM C . Clinical relevance of single item quality of life indicators in cancer clinical trials. Br J Cancer. 2001; 84(9):1156-65. PMC: 2363885. DOI: 10.1054/bjoc.2001.1785. View

Valderrabano F, Jofre R, Lopez-Gomez J . Quality of life in end-stage renal disease patients. Am J Kidney Dis. 2001; 38(3):443-64. DOI: 10.1053/ajkd.2001.26824. View

Kroenke K, Spitzer R, Williams J . The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16(9):606-13. PMC: 1495268. DOI: 10.1046/j.1525-1497.2001.016009606.x. View

Kusek J, Greene P, Wang S, Beck G, West D, Jamerson K . Cross-sectional study of health-related quality of life in African Americans with chronic renal insufficiency: the African American Study of Kidney Disease and Hypertension Trial. Am J Kidney Dis. 2002; 39(3):513-24. DOI: 10.1053/ajkd.2002.31401. View

Kimmel P . Depression in patients with chronic renal disease: what we know and what we need to know. J Psychosom Res. 2002; 53(4):951-6. DOI: 10.1016/s0022-3999(02)00310-0. View

10.

Walters B, Hays R, Spritzer K, Fridman M, Carter W . Health-related quality of life, depressive symptoms, anemia, and malnutrition at hemodialysis initiation. Am J Kidney Dis. 2002; 40(6):1185-94. DOI: 10.1053/ajkd.2002.36879. View

11.

Beattie M, Shlipak M, Liu H, Browner W, Schiller N, Whooley M . C-reactive protein and ischemia in users and nonusers of beta-blockers and statins: data from the Heart and Soul Study. Circulation. 2003; 107(2):245-50. PMC: 2776690. DOI: 10.1161/01.cir.0000044387.23578.e9. View

12.

Ruo B, Rumsfeld J, Hlatky M, Liu H, Browner W, Whooley M . Depressive symptoms and health-related quality of life: the Heart and Soul Study. JAMA. 2003; 290(2):215-21. PMC: 2776689. DOI: 10.1001/jama.290.2.215. View

13.

Ix J, Shlipak M, Liu H, Schiller N, Whooley M . Association between renal insufficiency and inducible ischemia in patients with coronary artery disease: the heart and soul study. J Am Soc Nephrol. 2003; 14(12):3233-8. PMC: 2770344. DOI: 10.1097/01.asn.0000095642.25603.7a. View

14.

Shlipak M, Stehman-Breen C, Fried L, Song X, Siscovick D, Fried L . The presence of frailty in elderly persons with chronic renal insufficiency. Am J Kidney Dis. 2004; 43(5):861-7. DOI: 10.1053/j.ajkd.2003.12.049. View

15.

Gottlieb S, Khatta M, Friedmann E, Einbinder L, Katzen S, Baker B . The influence of age, gender, and race on the prevalence of depression in heart failure patients. J Am Coll Cardiol. 2004; 43(9):1542-9. DOI: 10.1016/j.jacc.2003.10.064. View

16.

Mossey J, Shapiro E . Self-rated health: a predictor of mortality among the elderly. Am J Public Health. 1982; 72(8):800-8. PMC: 1650365. DOI: 10.2105/ajph.72.8.800. View

17.

Cohen S, Kamarck T, Mermelstein R . A global measure of perceived stress. J Health Soc Behav. 1983; 24(4):385-96. View

18.

Evans R, Manninen D, Garrison Jr L, HART L, Blagg C, Gutman R . The quality of life of patients with end-stage renal disease. N Engl J Med. 1985; 312(9):553-9. DOI: 10.1056/NEJM198502283120905. View

19.

Smith M, Hong B, Robson A . Diagnosis of depression in patients with end-stage renal disease. Comparative analysis. Am J Med. 1985; 79(2):160-6. DOI: 10.1016/0002-9343(85)90004-x. View

20.

Craven J, Rodin G, Littlefield C . The Beck Depression Inventory as a screening device for major depression in renal dialysis patients. Int J Psychiatry Med. 1988; 18(4):365-74. DOI: 10.2190/m1tx-v1ej-e43l-rklf. View