Sociodemographic factors contribute to the depressive affect among African Americans with chronic kidney disease

Abstract

Depression is common in end-stage renal disease and is associated with poor quality of life and higher mortality; however, little is known about depressive affect in earlier stages of chronic kidney disease. To measure this in a risk group burdened with hypertension and kidney disease, we conducted a cross-sectional analysis of individuals at enrollment in the African American Study of Kidney Disease and Hypertension Cohort Study. Depressive affect was assessed by the Beck Depression Inventory II and quality of life by the Medical Outcomes Study-Short Form and the Satisfaction with Life Scale. Beck Depression scores over 14 were deemed consistent with an increased depressive affect and linear regression analysis was used to identify factors associated with these scores. Among 628 subjects, 166 had scores over 14 but only 34 were prescribed antidepressants. The mean Beck Depression score of 11.0 varied with the estimated glomerular filtration rate (eGFR) from 10.7 (eGFR 50–60) to 16.0 (eGFR stage 5); however, there was no significant independent association between these. Unemployment, low income, and lower quality and satisfaction with life scale scores were independently and significantly associated with a higher Beck Depression score. Thus, our study shows that an increased depressive affect is highly prevalent in African Americans with chronic kidney disease, is infrequently treated with antidepressants, and is associated with poorer quality of life. Sociodemographic factors have especially strong associations with this increased depressive affect. Because this study was conducted in an African-American cohort, its findings may not be generalized to other ethnic groups.

Quality-of-Life and Mortality in Hemodialysis Patients

“…Our findings suggest that mental health is a stronger outcome predictor in AA MHD patients. Our findings of poor mental health score and poor clinical outcomes in AA MHD patients are consistent with a report of Fischer et al (62), who found, among a cohort of 628 AAs with stages 3 to 5 CKD, a high prevalence of increased depressive affect that was infrequently treated with anti-depressants and that was associated with poorer quality of life.…”

Prevalence and Factors Associated with Depressive Symptoms among Patient with Chronic Kidney Disease (CKD) in Black Lion Specialized Hospital and Saint Paulo’s Hospital Millennium Medical College, Addis Ababa, Ethiopia: Cross Sectional Study

“…Being female was significantly associated with depression. The finding is similar with the study conducted in USA [16]. Findings from different studies showed that depression is common in females.…”

Anxiety and depression in patients with end-stage renal disease: impact and management challenges – a narrative review

“…19 Similarly, the prevalence of at least moderate depressive symptoms was 26% among subjects with hypertensive CKD in the African-American Study of Kidney Disease and Hypertension Cohort Study. 20 The Cardiovascular Health Study found that in their community-based cohort of elderly subjects, those with depressive symptoms had 19% greater odds of impaired eGFR (95% CI=1.01-1.40) compared to those without, after adjustment for demographics, clinical variables, and health behaviors.…”