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Abstract: FR-PO948

Coping and Adverse Kidney Outcomes

Session Information

Category: CKD (Non-Dialysis)

  • 2203 CKD (Non-Dialysis): Mechanisms

Authors

  • Novick, Tessa Kimberly, The University of Texas at Austin Dell Medical School, Austin, Texas, United States
  • Custer, James, The University of Texas at Austin Dell Medical School, Austin, Texas, United States
  • Zonderman, Alan B., National Institute on Aging, Bethesda, Maryland, United States
  • Evans, Michele Kim, National Institute on Aging, Bethesda, Maryland, United States
  • Hladek, Melissa D., Johns Hopkins University, Baltimore, Maryland, United States
  • Kuczmarski, Marie, National Institute on Aging, Bethesda, Maryland, United States
  • Crews, Deidra C., Johns Hopkins University, Baltimore, Maryland, United States
Background

We evaluated whether coping behaviors were associated with incident CKD and rapid kidney function decline, and whether coping behaviors mediated associations between depressive symptoms and outcomes.

Methods

We used data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study for this analysis. Adaptive and maladaptive coping behaviors were measured using the Brief COPE Inventory at study visit 1, and analyzed as 2 continuous scales, with higher numbers reflecting higher self-reported use of the coping behaviors. We used multivariable logistic regression to assess the odds of incident CKD (eGFR <60 ml/min/1.73m2 and ≥25% decline at study visits 3 or 4 in relation to visit 1) and rapid kidney function decline (loss of >3 ml/min/1.73m2 per year) per point increase in coping scales. We evaluated for mediation of the relationship between depressive symptoms using the Center for Epidemiologic Studies Depression scale at visit 1 and outcomes by coping scales.

Results

Among 2336 participants, after a median of 8.2 years of follow-up, incident CKD and rapid kidney function decline occurred in 139 (9%) and 453 (31%) of participants. After multivariable adjustment, higher adaptive coping was associated with reduced odds of incident CKD (adjusted OR 0.97 per 1-point increase in adaptive score, 95% CI 0.95 – 0.99; Table 1). Higher adaptive coping mediated the association between high versus low depressive symptoms and incident CKD (average causal mediation effect [ACME] 0.009, p = 0.03 for adaptive; ACME -0.002, p = 0.90 for maladaptive). Coping behaviors were not associated with rapid decline, nor did they mediate associations between depressive symptoms and rapid decline.

Conclusion

Adaptive coping behaviors could represent a target for CKD prevention interventions.

Funding

  • Other NIH Support