Abstract: SA-PO451

Prevalent Depression and Associated Factors in a Disadvantaged CKD Population

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 306 CKD: Cognitive Dysfunction, Depression, Quality of Life

Authors

  • Walther, Carl P., Baylor College of Medicine, Houston, Texas, United States
  • Niu, Jingbo, Baylor College of Medicine, Houston, Texas, United States
  • Saridey, Sai Kaumudi, Baylor College of Medicine, Houston, Texas, United States
  • Winkelmayer, Wolfgang C., Baylor College of Medicine, Houston, Texas, United States
  • Navaneethan, Sankar D., Baylor College of Medicine, Houston, Texas, United States
Background

Depression is common among individuals with CKD and associated with adverse outcomes. In the US population, prevalence is lower in older persons and varies with race/ethnicity. We studied factors associated with depression in a diverse non-dialysis CKD cohort, which could help to identify high-risk patients and disparities.

Methods

We identified adults with eGFR <60 for ≥90 days who received care through a safety-net health system from 2006-16. Depression was determined from ICD codes prior to or within 2 weeks of cohort entry. Comorbidities were identified using a similar method. We categorized CKD into stages 3A, 3B, 4, and 5. Race/ethnicity was recorded in 5 mutually-exclusive categories. We used multivariate logistic regression to analyze associations with demographics, comorbidities, and CKD stage, and calculated predicted probabilities and 95% CIs.

Results

We included 13678 CKD patients of whom 39.4% were Hispanic, 40.9% black, 11.5% white, 5.9% Asian/Pacific Islander, and 2.2% other/unknown race. Depression prevalence was 11.6% overall, and 23.9% among whites, 11.1% among blacks, 9.8% among Hispanics, and 5.3% among Asians/PIs. Interactions between age and race/ethnicity, and between age and number of comorbidities were observed.

Conclusion

Depression prevalence varied with race/ethnicity, age, and comorbidities. Depression decreased markedly with age in blacks and whites, but not Hispanics. The association of comorbidities with depression decreased with age.

Stratified Odds Ratios [95% CIs] for Depression*
Age category (years)
Hispanic (versus black or white)†One additional comorbidity‡
18 to 340.30 (0.11-0.87)2.63 (1.56-4.43)
35 to 490.50 (0.36-0.69)1.70 (1.49-1.93)
50 to 640.76 (0.65-0.89)1.59 (1.50-1.68)
65 to 790.87 (0.68-1.11)1.59 (1.56-1.73)
80 or older1.61 (0.94-2.77)1.23 (1.03-1.46)

*Adjusted for CKD stage, sex, cohort year, continuous age, and either †comorbidity count or ‡race/ethnicity