Social Isolation Is Associated With Rapid Kidney Function Decline and the Development of Chronic Kidney Diseases in Middle-Aged and Elderly Adults: Findings From the China Health and Retirement Longitudinal Study (CHARLS)

Zhou, Weiran; Li, Yang; Ning, Yuping; Gong, Shaomin; Song, Nana; Zhu, Bowen; Wang, Jialin; Zhao, Shuan; Shi, Yiqin; Ding, Xiaoqiang

doi:10.3389/fmed.2021.782624

Cited by 14 publications

(18 citation statements)

References 48 publications

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“…Predialysis patients usually have significant muscle atrophy, which is the main factor for weakness [ 14 ]. Similarly, older patients on hemodialysis are gradually isolated from their social environment due to comorbid diseases, deaths of family members, physical weakness, and hearing loss [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…The present study also found that pensioners had statistically high levels of depression. This can be attributed to the fact that retirement usually leads to social isolation in older adults, which is a significant factor in depression [ 15 ]. Additionally, retirement has a close relationship with decreased working ability in these patients, since working-age individuals on hemodialysis have difficulties in maintaining employment due to co-morbid diseases, increased fatigue, frequent hospitalizations, and the long duration of hemodialysis sessions, each lasting four hours, three times a week [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

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Depression Among Hemodialysis Patients: Related Factors and the Impact of Insomnia and Fatigue

Sakiqi¹,

Vasilopoulos²,

Koutelekos³

et al. 2022

Cureus

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Introduction: Depression is a commonly experienced psychological disorder among patients undergoing hemodialysis and has a strong association with insomnia and fatigue. The purpose of the present study was to explore the factors related to depression in dialysis patients and the impact of insomnia and fatigue on depression. Methods: In this cross-sectional study, one hundred (n=100) patients on hemodialysis from one hemodialysis center in Greece participated. Data collection was carried out by interviews using the Zung Self-rating Depression Scale (SDS) for the evaluation of depression; the Athens Insomnia Scale (AIS) for the evaluation of insomnia; the Modified Fatigue Impact Scale (MFIS) for the evaluation of fatigue; and a questionnaire which was created by the researchers. The Kruskal-Wallis, the Mann-Whitney tests, and the Spearman's rho criterion were used to evaluate the relationship between depression score and patient characteristics. Multiple linear regression was performed to assess the effect of characteristics on patients' depression. Results: Statistically significantly high levels of depression were found in patients over the age of 70 years old (p=0.001), in divorced/widowed patients (p = 0.001), in pensioners (p = 0.002), in patients who had other diseases (p = 0.001), in those who felt tired after hemodialysis or at night and those who felt constantly tired (p = 0.001, p = 0.016, and p = 0.001, respectively), in those who had physical and mental fatigue (p = 0.001 and p = 0.001, respectively), in those who had changes in body image (p = 0.009), itching, stiffness, and nausea/vomiting (p = 0.001, p = 0.001, and p = 0.003, respectively), in patients who had restrictions in clothes they could wear (p = 0.001), in patients who had insomnia (p = 0.001), and in patients who did not wish to receive written information about the management of their disease (p = 0.025). A statistically significant positive linear association was detected between physical/mental fatigue and depression levels (rho = 0.824 and rho = 0.746, respectively) and between the score of insomnia and depression levels (rho = 0.707). An increase in fatigue (either physical or mental) and an increase in insomnia score also indicated an increase in depression levels. Conclusions: The findings of this study showed that depression had a strong association with a variety of demographic factors. Additionally, an increase in fatigue score and an increase in insomnia score indicated an increase in depression levels. Therefore, depression, insomnia, and fatigue should be early assessed and effectively treated by renal professionals in order to improve the quality of life in hemodialysis patients and reduce their morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Depression Among Hemodialysis Patients: Related Factors and the Impact of Insomnia and Fatigue

Sakiqi¹,

Vasilopoulos²,

Koutelekos³

et al. 2022

Cureus

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“…The primary outcome was a rapid decrease in eGFR, as defined by a reduction of > 5 mL·min –1 ·(1.73 m 2 ) –1 /year [ 22 , 23 ]. A reduction in eGFR of > 15 mL/min·(1.73 m 2 ) after three years was considered to indicate the progression of kidney function.…”

Section: Methodsmentioning

confidence: 99%

Correlation between the increase in serum uric acid and the rapid decline in kidney function in adults with normal kidney function: a retrospective study in Urumqi, China

Yang

et al. 2023

BMC Nephrol

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Background To examine the association between elevated serum uric acid (SUA) levels and the rapid decline in kidney function by conducting a retrospective cohort study on a physically healthy population in Urumqi, China. Methods A cohort study of 2,802 physically healthy people with a normal estimated glomerular filtration rate (eGFR) was investigated from 2018 to 2021. The examination procedure included using questionnaires, taking physical measurements, and blood sampling. The rapid decline in kidney function was defined as eGFR > 5 mL·min–1 ·(1.73 m2 )–1 year. The relationship between elevated SUA levels and the rapid decline in kidney function was assessed. Results When performing the three-year retrospective analysis, 688 (28.55%) cases experienced a rapid decline in kidney function, and 52 (1.9%) cases developed chronic kidney disease (CKD). They were divided into the stable group and the rapidly declining kidney function group according to eGFR > 15 mL·min–1·(1.73 m2 )–1. The comparison revealed a greater increase in uric acid in the rapidly declining kidney function group [0.30 (-0.29, 0.82) mg/dL vs. − 0.07(-0.54, 0.37) mg/dL, Z = − 8.822, P < 0.001]. The participants were further divided into four groups according to their uric acid levels in 2018 and 2021, which included the normal to normal (N-N) group, the normal to hyperuricemia (HUA) (N-H) group, the HUA to normal (H-N) group, and the persistently HUA (H-H) group. The decrease in eGFR was significantly higher in the N-H group than in the other three groups (χ2 = 20.580, P < 0.001). The results of the multifactorial logistic regression analysis showed that elevated uric acid was a risk factor for the rapid decline in kidney function (OR = 1.640, P < 0.001). Conclusion Elevated SUA levels were a risk factor for the rapid decline in kidney function in the Chinese health examination population. Higher SUA levels might predict the occurrence of progressive kidney impairment.

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“…94 In a study including 3031 individuals with baseline estimated glomerular filtration rates (eGFR) ≥ 60 mL/min/1.73 m 2 , Zhou et al showed an independent association between social isolation and the risk of rapid fall in the eGFR as well as CKD onset. 94 In another study, Moorthi et al showed that individuals with CKD stage 3b-5 had significantly decreased social contact and social participation and mobility limitation was an important risk factor for these conditions. 95 A recent review also discusses the impact of loneliness in the development of anorexia in older patients with endstage renal disease.…”

Section: Chronic Kidney Diseasementioning

confidence: 99%

Social isolation and loneliness: Undervalued risk factors for disease states and mortality

Kanbay

Tanrıöver

Çöpür

et al. 2023

Eur J Clin Investigation

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Social isolation and loneliness are two common but undervalued conditions associated with a poor quality of life, decreased overall health and mortality. In this review, we aim to discuss the health consequences of social isolation and loneliness. We first provide the potential causes of these two conditions. Then, we explain the pathophysiological processes underlying the effects of social isolation and loneliness in disease states. Afterwards, we explain the important associations between these conditions and different non‐communicable diseases, as well as the impact of social isolation and loneliness on health‐related behaviours. Finally, we discuss the current and novel potential management strategies for these conditions. Healthcare professionals who attend to socially isolated and/or lonely patients should be fully competent in these conditions and assess their patients thoroughly to detect and properly understand the effects of isolation and loneliness. Patients should be offered education and treatment alternatives through shared decision‐making. Future studies are needed to understand the underlying mechanisms better and to improve the treatment strategies for both social isolation and loneliness.

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Social Isolation Is Associated With Rapid Kidney Function Decline and the Development of Chronic Kidney Diseases in Middle-Aged and Elderly Adults: Findings From the China Health and Retirement Longitudinal Study (CHARLS)

Cited by 14 publications

References 48 publications

Depression Among Hemodialysis Patients: Related Factors and the Impact of Insomnia and Fatigue

Depression Among Hemodialysis Patients: Related Factors and the Impact of Insomnia and Fatigue

Correlation between the increase in serum uric acid and the rapid decline in kidney function in adults with normal kidney function: a retrospective study in Urumqi, China

Social isolation and loneliness: Undervalued risk factors for disease states and mortality

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