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Abstract: PO2406

Depressive Symptom Trajectory and CKD Progression: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Missikpode, Celestin, University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Ricardo, Ana C., University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Durazo-Arvizu, Ramon, University of Southern California, Los Angeles, California, United States
  • Brown, Julia, University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Fischer, Michael J., University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Hernandez, Rosalba, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
  • Porter, Anna C., University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Lash, James P., University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
Background

While depressive symptoms (DS) are highly prevalent in adults with early-stage chronic kidney disease (CKD), little is known about its course over time. We identified trajectories of DS and evaluated their association with CKD progression in adults with CKD enrolled in the CRIC study.

Methods

DS were assessed using the Beck Depression Inventory (BDI), at baseline and biennially. Higher BDI scores are consistent with more severe DS. Glomerular filtration rate (GFR) was estimated at baseline and annually. Group-based trajectory models were used to determine trajectories of BDI and eGFR over time. The association between these trajectories was assessed using multinomial logistic regression, adjusting for socio-demographics, lifestyle factors, and comorbidities.

Results

Among 3113 participants at baseline: µage=58 years, 45.5% female, µeGFR=47 mL/min/1.73 m2 and µBDI=7.6. We identified three BDI trajectory patterns (persistently low, persistently moderate, and persistently high [Figure 1a]), and three trajectory patterns for eGFR (non-linear decline, linear decline, and stable [Figure 1b]). Odds of non-linear eGFR decline were higher for adults with persistently moderate BDI (OR, 1.51; 95% CI, 1.11-2.06) and those with persistently high BDI (OR, 1.75; 95% CI, 0.99-3.07), compared to counterparts with persistently low BDI scores. No association was evident between BDI scores and linear eGFR decline.

Conclusion

In this CKD cohort, moderate and high DS that persisted over time were associated with non-linear eGFR decline. Intervention studies are warranted to test the effect of depression prevention and treatment on CKD progression.