Kidney Week

Abstract: SA-PO0494

Stage-Dependent Risk of Incident Depression Across Cardiovascular-Kidney-Metabolic Stages: A Nationwide Cohort Study

Session Information

• CKM: Clinical - Screening, Population Management, Care Disparities, and Patient-Centered Outcomes
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Cardiovascular-Kidney-Metabolic Health

• 602 Cardiovascular-Kidney-Metabolic Health: Clinical

Authors

• Lee, Soojin, Eulji University Uijeongbu Eulji Medical Center, Uijeongbu-si, Gyeonggi-do, Korea (the Republic of)

Soojin Lee, MD, PhD

• Kim, Seong Geun, Gangnam Severance Hospital, Seoul, Korea (the Republic of)

Seong Geun Kim, MD

• Kim, Minsang, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Minsang Kim, MD

• Cho, Semin, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si, Gyeonggi-do, Korea (the Republic of)

Semin Cho, MD

• Park, Sehoon, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Sehoon Park, MD, PhD

• Kim, Yaerim, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Yaerim Kim, MD, PhD

• Han, Kyungdo, Soongsil University, Dongjak-gu, Seoul, Korea (the Republic of)

Kyungdo Han, PhD

• Kim, Dong Ki, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)

Dong Ki Kim, MD, PhD

Background

Cardiovascular–kidney–metabolic (CKM) syndrome integrates cardiovascular, kidney, and metabolic diseases that share common risk factors and biological mechanisms. Although previous studies have demonstrated associations between CKM and various diseases, its relationship with depression remains insufficiently characterized.

Methods

We conducted a nationwide population-based cohort study using data from Korean National Health Insurance Service. The participants who underwent health screening in 2012 were considered. CKM stage was classified based on American Heart Association CKM staging system. Cox proportional hazards models were used to estimate risks for incident depression according to CKM stage.

Results

A total of 3,912,670 individuals were included. Compared with stage 0, stage 1 showed a slightly lower risk, followed by a progressive increase from stage 2 (adjusted HRs 1.021 [1.015–1.028] for stage 2, 1.252 [1.236–1.267] for stage 3, and 1.454 [1.438–1.470] for stage 4; P < 0.001) (Figure 1). This pattern was consistently observed among individuals with preserved kidney function. In stratified analyses, the association varied by sex and age, with a more pronounced increase in risk observed in men, while the stage-dependent pattern differed across age groups (P for interaction < 0.001) (Figure 2).

Conclusion

Higher CKM stages were associated with an increased risk of incident depression in a nonlinear, stage-dependent relationship. These findings suggest that CKM staging may serve as a clinically relevant marker for identifying individuals at increased risk of depression and highlight the need for integrated management strategies.