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Abstract: PO0437

Increased Risk of Progression to ESRD or Death in CKD Patients with Symptoms of Depression: A Systematic Review and Meta-Analysis of Cohort Studies

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Zeng, Jiahao, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
  • Qin, Xindong, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China, Guangzhou, China
  • Liu, Xusheng, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China, Guangzhou, China

Comorbid symptoms of depression are common psychiatric disorder in patients with chronic kidney disease (CKD). It remains unclear whether it is an independent risk factor for progression of patients with CKD not requiring dialysis. We conducted a systematic review to assess the association of depressive symptoms with poor clinical outcomes in patients with CKD not requiring dialysis.


PubMed, Embase and CINAHL were searched (up to February 15th, 2020) for cohort studies assessing the association of depression with progression to end-stage renal disease (ESRD), defined as requiring maintenance dialysis, or all-cause mortality in patients with CKD not requiring maintenance dialysis. Two independent researchers extracted data, assessed risk of bias and evidence certainty.


Seven cohort studies of 6145 patients were included. Methodological quality of studies was generally low risk of bias. Compared with non-depression or low depressive symptoms, high depressive symptoms increased the risk of progression to ESRD (HR, 2.09 95%CI 1.43 to 3.07, I2=37%), all-cause mortality (HR, 1.51 95%CI 1.13 to 2.01, I2=57%) and hospitalization (HR, 1.52 95%CI 1.20 to 1.93, I2=32%).


Depressive symptoms in CKD are independent risk factors of poor clinical outcomes, including ESRD, all-cause death, and hospitalization. There is necessary to design high quality studies to assess the effects of treating depressive symptoms in patients with CKD.