Researchers Report Tie Between Depression And Chronic Kidney Disease

A new study finds that one in five patients with chronic kidney disease is depressed, even before beginning long-term dialysis therapy or developing end-stage renal disease.

Researchers at UT Southwestern Medical Center conducted the first study to examine the relationship. 

Medical experts have noted that patients in the early stages of chronic kidney disease are at increased risk for clinical depression according to the study in the current issue of the American Journal of Kidney Diseases.

Previous research has shown that depression rates in the general community are 2 percent to 4 percent.  Among diabetes patients, the rate is 11 percent.  Among congestive heart failure patients, 14 percent; and among coronary artery disease after heart attack patients, 16 percent.

Chronic kidney disease patient depression numbers may be higher due to the presence of the same simultaneously occurring conditions that resulted in progressive kidney disease, such as diabetes and atherosclerotic vascular disease, one of the researchers noted.  Patients such as diabetics, who are depressed, may develop progressive kidney disease because of non-adherence to medications and physicians' advice.

From May 2005 to November 2006, researchers invited patients at the Dallas VA Medical Center who were visiting the clinic for chronic kidney disease appointments to join the study. Patients who agreed to participate then underwent a structured clinical interview to determine if they had a current major depressive episode, based on the DSM IV definition of major depressive disorder.

Some 21 percent were found to be depressed. The mean age of depressed patients was about 65.  The researchers also found that diabetic patients were twice as likely to be depressed as those without diabetes; 63 percent of patients had at least three other medical conditions; and 41 percent had at least four other diseases.

According to the American Association for Critical Illness Insurance, some 26 million Americans have chronic kidney disease and millions more are at increased risk. If treatment does not begin early, the condition progresses to end-stage renal disease. At that point, a patient's kidneys have failed to the point where dialysis is needed.  Dialysis involves filtering of toxic chemicals in the blood and removing fluid to help control blood pressure.

Expenditures for end-stage renal disease patients totaled $15.5 billion, which is approximately 6 percent of the entire Medicare budget, and are projected to consume $28 billion by 2010.