According to a study recently published in the American Journal of Kidney Disease, one in five people with chronic kidney disease is depressed, even before beginning long-term dialysis or developing end-stage kidney disease. The National Kidney Foundation reports that 26 million people have chronic kidney disease, and that millions more people, including those with diabetes, are at increased risk of developing the condition.
Researchers recruited participants who were visiting the Dallas VA Medical Center for chronic kidney disease appointments from May 2005 to November 2006. Those who joined the study were interviewed and assessed for major depression based on the definition of the condition in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV), considered the gold standard for evaluating depression. (Previous research on this topic has based estimates of depression among people with chronic kidney disease on self-reported depression scales.)
Fifty-seven of the 272 people involved, or 21%, were found to be depressed. The average age of the depressed people, all of whom were veterans, was 65, and nearly 56% of the depressed people were white. The researchers found that people with diabetes were more than twice as likely to be depressed as those without diabetes.
According to lead study author Susan Hedayati, MD, MHSc, “Chronic kidney disease patient depression numbers may be higher due to the presence of the same simultaneously occurring conditions that resulted in progressive kidney disease, such as diabetes and atherosclerotic vascular disease. Alternatively, patients such as diabetics who are depressed may develop progressive kidney disease because of nonadherence to medications and physicians’ advice.”
Dr. Hedayati is currently conducting the Chronic Kidney Disease Antidepressant Sertraline Trial (CAST) to determine whether antidepressant medicines would be tolerated and effective in people with kidney disease.
For more information, see “Link Found Between Depression, Early Stages of Chronic Kidney Disease.” And to learn more about kidney disease, read “Protecting Your Kidneys.”
Which comes first, the depression or the
kidney disease? Or the diabetes? Managing
a chronic illness, or several, is very time
consuming, at the same time that the condition
slows us down. We become consumed by our
conditions, even those of us who are
determined to be Helen, and not the diabetic,
or the person with one kidney.
It is important to find out if the brain and
chemical changes that may come with
depression impact the progression of the
illnesses.
It is also important to implement preventive
Posted by Helen Mueller | Nov 02, 2009 at 3:53 pmtherapies before the depression takes hold
of a person. I once belonged, very briefly, to
a wellness center. The insurance mandated
attendance there if you had diabetes. For the
short time I attended, I learned they were
very aware of the depression self treating
diabetes can bring and they had tools in place
to ameliorate the condition. Alas, their bottom
line was not where the parent company wanted
it and that health plan was pulled from the
market.