The prevalence of depression and the association between depression and kidney function and health-related quality of life in elderly patients with chronic kidney disease: a multicenter cross-sectional study

Figures & data

Table 1 Characteristics of responders and nonresponders

Variables	Responders (N=1079)	Nonresponders (N=84)	P-value
Age	68.8±6.6	74.6±8.5	<0.001
Sex: male	676(62.7)	47(56.0)	0.223
Hypertension(N=1129)	830(77.1)	44(84.6)	0.204
Diabetes(N=1132)	402(37.3)	30 (54.5)	0.010
CVD(N=1128)	256(23.8)	13(25)	0.842
eGFR(mL/min/1.73m^2)	54.90±32.22	45.13±23.70	0.001

Notes: The bold values were statistically significant with P<0.05. Values for continuous variables were expressed as mean ± SD, categorical variables were number (% of group).

Abbreviations: CVD, Cardiovascular diseases; eGFR, estimated glomerular filtration rate.

Table 2 Characteristics of CKD patients by depressive symptoms

Variables	Total	Depressed	Nondepressed	P-value
No. of patients	1079 (100)	248 (23.0)	831 (77.0)	–
Age	68.8±6.6	69.0±6.5	68.8±6.6	0.610
Sex: male	676 (62.7)	144(58.1)	532(64.0)	0.089
Marital status (N=1067)				0.017
Married	1005(94.2)	224(91.1)	781(95.1)
Others	62(5.8)	22(8.9)	40(4.9)
Education (N=976)				0.002
0–6 years	307(31.5)	92(41.3)	215 (28.6)
7–12 years	513(52.6)	102(45.7)	411(54.6)
>12 years	156(16.0)	29(3.0)	127(16.9)
Annual household income (N=948)				0.055
<50,000 RMB	460(48.5)	123(54.9)	337(46.5)
50,000–100,000 RMB	274(28.9)	52(23.2)	222(30.7)
≥100,000 RMB	214(22.6)	49(21.9)	165(22.8)
Hypertension(N=1077)	830 (77.1)	190(76.6)	640(77.2)	0.847
Diabetes(N=1077)	402 (37.3)	77(31.0)	325 (39.2)	0.020
CVD(N=1076)	256 (23.7)	77(31.0)	179(21.6)	0.002
Current smoking(N=1077)	145 (13.5)	29(11.7)	116(14.0)	0.366
Current drinking(N=1075)	315(29.2)	64(26.0)	251(30.3)	0.197
BMI(N=1066), kg/m^2	25.08±3.49	24.86±3.52	25.14±3.48	0.272
eGFR, mL/min/1.73 m^2	54.90±32.22	49.17±32.00	56.60±32.10	0.001
CKD stage				<0.001
CKD1-2	390(36.1)	77(31.0)	313(37.7)
CKD3	403(37.3)	80(32.3)	323(38.9)
CKD4	236(21.9)	65(26.2)	175(20.6)
CKD5	50(4.6)	26(10.5)	24(2.9)
Proteinuria (N=969) g/day	2.63±2.77	3.01±2.80	2.52±2.76	0.024
Hemoglobin(N=1066), g/L	121.31±20.59	116.09±21.04	121.57±20.30	<0.001
Serum albumin(N=1067), g/L	34.45±8.65	34.69±8.49	34.37±8.71	0.615
Uric acid(N=1071), μmol/L	397.83±107.51	394.48±114.10	398.84±105.51	0.576
Calcium(N=1044), mmol/L	2.16±0.25	2.17±0.23	2.16±0.25	0.581
Phosphate(N=1026), mmol/L	1.19±0.23	1.23±0.29	1.18±0.21	0.013
NLR (N=1057)	2.95±2.62	3.22±2.31	2.87±2.70	0.076
PLR(N=1055)	133.79±79.30	138.49±66.28	132.42±82.69	0.299
Total cholesterol (N=1022), mmol/L	5.22±1.86	5.16±1.79	5.23±1.88	0.614
Triglycerides (N=1019), mmol/L	1.99±1.28	1.97±1.08	2.00±1.34	0.803
HDL(N=977), mmol/L	1.24±0.42	1.22±0.42	1.24±0.42	0.529
LDL(N=977), mmol/L	3.19±1.50	3.07±1.43	3.22±1.51	0.194

Notes: The bold values were statistically significant with P<0.05. Values for continuous variables were expressed as the mean ± SD, or median with interquartile ranges. Categorical variables were number (% of group).

Abbreviations: CVD, Cardiovascular diseases; BMI, body-mass index; eGFR, estimated glomerular filtration rate; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; HDL, high-density lipoprotein; LDL, low-density lipoprotein; CKD, chronic kidney disease.

Figure 1 Association between depressive symptoms and eGFR.

Abbreviations: eGFR, estimated glomerular filtration rate; GDS, Geriatric Depression Scale.

Table 3 Multiple logistic regression analysis parameters (dependent variable - depression)

Predictor	B	Wald	Exp (β)	95% CI (Exp [β])	P-value
Marital status	−0.601	4.343	0.548	(0.312 to 0.965)	0.037
Education
≤6	Referent	Referent	Referent	Referent	Referent
7–12	−0.575	11.701	0.563	(0.405 to 0.782)	0.001
≥12	−0.570	5.197	0.565	(0.346 to 0.923)	0.023
Diabetes	−0.511	9.591	0.600	(0.434 to 0.829)	0.002
CVD	0.643	14.083	1.902	(1.360 to 2.661)	<0.001
CKD stage
CKD1-2	Referent	Referent	Referent	Referent	Referent
CKD3	−0.011	0.003	0.989	(0.689 to 1.420)	0.954
CKD4	0.433	4.652	1.541	(1.040 to 2.283)	0.031
CKD5	1.643	26.138	5.171	(2.754 to 9.709)	<0.001
Proteinuria	0.056	4.105	1.057	(1.002 to 1.116)	0.043

Notes: The predictors were accepted according to a stepwise algorithm (inclusion criteria: P<0.05, exclusion criteria: P>0.10).

Abbreviations: CVD, Cardiovascular diseases; CKD, chronic kidney disease.

Table 4 HRQOL components of CKD patients by depressive symptoms

Variables	Total (N=1079)	Depressed (N=248)	Nondepressed (N=831)	P-value
GH	44.74±20.29	36.19±18.78	47.29±20.03	<0.001
PF	65.47±33.02	46.37±35.38	71.17±30.02	<0.001
RP	64.01±43.40	69.35±42.41	64.17±43.23	<0.001
BP	77.39±24.98	39.11±44.11	71.45±40.44	<0.001
RE	80.75±36.67	59.48±45.00	87.11±31.10	<0.001
MH	82.89±17.83	71.22±21.20	86.21±15.20	<0.001
VT	71.53±26.93	53.12±28.90	77.01±23.71	<0.001
SF	78.67±28.27	62.70±31.97	83.45±25.19	<0.001
PCS	49.97±9.13	44.72±9.79	51.54±8.31	<0.001
MCS	50.03±9.14	43.22±11.03	52.07±7.37	<0.001
Burden of kidney disease	55.38±25.32	39.32±24.18	60.18±23.64	<0.001
Symptoms and problems of kidney disease	88.69±10.36	81.24±13.40	90.92±8.02	<0.001
Effects of kidney disease	89.67±12.02	81.47±15.93	92.13±9.26	<0.001

Notes: The bold values were statistically significant with P<0.05. Values were expressed as the mean ± SD.

Abbreviations: GH, general health; PF, physical functioning; RP, role-physical; BP, bodily pain; RE, role-emotional; MH, mental health; VT, vitality; SF, social functioning; PCS, physical component summary; MCS, mental component summary.

Table 5 Correlation and linear regression between GDS score and HRQOL subscales

	Correlation		Linear regression
r	P-value	B	P-value
PCS	−0.370	<0.001	−1.014	<0.001
MCS	−0.412	<0.001	−1.397	<0.001
Burden of kidney disease	−0.403	<0.001	−3.332	<0.001
Symptoms and problems of kidney disease	−0.360	<0.001	−1.264	<0.001
Effects of kidney disease	−0.355	<0.001	−1.667	<0.001

Notes: Predictors in the model: sex, age, BMI, diabetes, cardiovascular disease, proteinuria, eGFR and GDS score.

Abbreviations: PCS, physical component summary; MCS, mental component summary; GDS, Geriatric Depression Scale; HRQOL, health-related quality of life.