Original InvestigationPathogenesis and Treatment of Kidney DiseaseAssociation Between Estimated GFR, Health-Related Quality of Life, and Depression Among Older Adults With Diabetes: The Diabetes and Aging Study
Section snippets
Study Design
In 2005-2006, the DISTANCE survey collected information about demographics, health behaviors, social support, and patient-provider interactions from a race-stratified random sample of members of the diabetes registry of Kaiser Permanente Northern California, an integrated health care delivery system. The diabetes registry consists of all patients within the Kaiser Permanente Northern California health system with diabetes identified from automated databases of pharmacy data, laboratory data,
Patient Characteristics
There were 5,805 respondents 60 years or older who had an identifiable eGFR measurement and who completed the HRQoL questionnaire (Fig 1). The distribution of patients in each eGFR category (all in mL/min/1.73 m2) was as follows: eGFR ≥90 (referent group), 1,222 (21.1%); eGFR of 75-89, 1,513 (26.1%); eGFR of 60-74, 1,602 (27.5%); eGFR of 45-59, 959 (16.5%); eGFR of 30-44, 392 (6.8%); and eGFR ≤29, 117 (2.0%; Table 1). Mean age was 67.2 ± 4.8 (SD) years, with the youngest mean age in respondents
Discussion
This study assessed the relationship between eGFR and HRQoL and depressive symptoms in a population of more than 5,800 community-dwelling insured older adults with diabetes enrolled in Kaiser Permanente Northern California. In this study, we found that after adjustment, there was no substantive relationship between eGFR and physical or mental HRQoL as a whole or separately in those with and without proteinuria. However, we also found that respondents with the lowest eGFRs (eGFR ≤29 mL/min/1.73 m
Acknowledgements
Support: Dr Campbell is supported by a T. Franklin Williams Scholars Award. Funding was provided by Atlantic Philanthropies, Inc; the American Geriatrics Society Foundation for Health in Aging; the John A. Hartford Foundation; and the Association of Specialty Professors. The Diabetes and Aging Study was supported by funding from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK; grants R01DK081796, R01DK080726, and R01DK65664). Investigators also were supported by the
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Cited by (32)
Associations of diabetes severity and risk of depression: a population-based cohort study
2020, Journal of Affective DisordersCystatin C and risk of new-onset depressive symptoms among individuals with a normal creatinine-based estimated glomerular filtration rate: A prospective cohort study
2019, Psychiatry ResearchCitation Excerpt :A recent meta-analysis reported that the prevalence of depressive symptoms was as high as 40% among CKD patients (Palmer et al., 2013). Several previous studies suggested that impaired renal function measured by estimated GFR may be associated with depressive symptoms (Abdel-Kader et al., 2009; Fischer et al., 2012; Liu et al., 2018), whereas other studies did not find this association (Campbell et al., 2013; Fischer et al., 2010; Martens et al., 2016). For example, in the Chronic Renal Insufficiency Cohort (CRIC) Study, Fischer et al. found that there were an 8% increased odds of depressive symptoms for every 10 ml/min/1.73 m2 decrease in GFR in the fully adjusted model (Fischer et al., 2012).
Response to cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus and chronic kidney disease
2017, Journal of Diabetes and its ComplicationsCKD and health-related quality of life: The korea national health and nutrition examination survey
2016, American Journal of Kidney DiseasesCitation Excerpt :Among the 5,555 adults from KNHANES III, patients with eGFRs of 30 to 59 mL/min/1.73 m2, as assessed by the MDRD Study equation, had an almost 1.5-fold higher risk for HRQoL impairment compared with those with eGFRs ≥ 90 mL/min/1.73 m2.9 However, the Heart and Soul Study of 967 outpatients with coronary artery disease did not show a statistically significant difference in risk for HRQoL impairment according to a creatinine clearance cutoff of 60 mL/min after adjusting for sociodemographics and comorbid conditions,11 and a recent study of 5,805 adults 60 years or older with diabetes showed that differences in HRQoL score according to eGFR category were no longer significant after adjusting for all analyzed factors, including cardiovascular disease.12 Thus, overall, results of previous studies in this field have been inconclusive and controversial for the past decade.
Originally published online June 7, 2013.