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Am J Kidney Dis. 2012 Jul;60(1):27-38. doi: 10.1053/j.ajkd.2011.12.033. Epub 2012 Apr 11.

Factors associated with depressive symptoms and use of antidepressant medications among participants in the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC Studies.

Collaborators (217)

Feldman HI, Landis JR, Appleby DH, Ballard S, Cifelli D, Curley RM, Dickson J, Durborow M, Durborow S, Glenn M, Hanish A, Helker C, Helker ES, Anderson AH, Joffe M, Kasner S, Kimmel SE, Kumanyika S, Nessel L, Mohler ER 3rd, Messe SR, Robinson N, Rosen L, Schwartz JS, Smith S, Stahl J, Tao K, Teal VL, Wang X, Xie D, Yang P, Zhang X, Townsend RR, Balaram M, Cappola TP, Cohen D, Cuevas M, Duckworth MJ, Dries DL, Ford V, Gorman CM, Grunwald J, Hannah HM, Kanetsky PA, Kellem K, Kibe L, Leonard MB, Maguire M, McDowell S, Murphy J, Reilly M, Rosas SE, Seamon WM, Sheridan A, Teff K, Appel LJ, Anderson C, Charleston J, Etheredge N, Jaar B, Mantegna K, Martin C, Miller EP, Scialla J, Sozio S, Turban S, Venkatesh H, Fink J, Fink W, Parsa A, Scism B, Seliger S, Weir M, Rahman M, Corrigan V, Dancie R, Kisin G, Kanthety R, Strauss L, Wright JT Jr, Schelling J, Kao P, Horowitz E, Bjaloncik J, Fallon T, Sedor JR, Shella MA, Theurer J, Thornton JD, Schreiber MJ, Coleman M, Fatica R, Halliburton S, Horner C, Markle T, Rafey MA, Russo A, Slattery S, Spirko R, Stelmach K, Stephens V, Danziger-Isakov L, Ojo A, Sundaram B, Briesmiester J, Cornish-Zirker D, Gadegbeku C, Hill N, Jamerson K, Kretzler M, Robinson B, Saran R, Welliver B, Wilson J, Young E, Steigerwalt SP, Bellovich K, DeLuca J, Gasko S, Makos G, Parmelee C, Smith S, Walls K, Flack JM, Sondheimer J, Maysura M, Migdal S, Mohanty J, Zhuang Y, Lash JP, Arruda J, Brecklin C, Carmona E, Cohan J, Fischer M, Frydrych A, Lopez A, Lora C, Martinez M, Matos A, Mercado A, Moreno B, Meslar P, Ricardo A, Stamos T, Cauter EV, He J, Alper B, Batuman V, Bazzano LA, Borja B, Burridge A, Chen J, Cooke C, Delafontaine P, DeSalvo KB, Fonseca VA, Hamm L, Hurly MR, Legarde J, Lustigova E, Muntner P, Patrocollo-Emerson M, Powers L, Shelton S, Starcke C, Whelton P, Go AS, Ackerson LM, Dorin P, Fernandez D, Jensvold NG, Lo JC, Ordonez JD, Perloff R, Tan T, Thompson D, Valladares GM, Wiggins A, Wong DB, Yang J, Hsu CY, Chertow GM, Bansal N, Kurella M, Shlipak MG, Yaffe K, Kusek JW, Narva AS, Faber-Langendoen K, Kiberd BA, Lee ET, Lewis J, McClellan W, Meyer T, Nathan D, Stokes JB, Taylor H, Wilson PW, Shah V, Raj D, Wolf M, Ridker PM, Rader DJ, DiFlorio A, Mifflin T, Morrell L, Wolfe ML, Hall P, Rolin H, Saunders S, Budoff M, Dailing C, Soliman EZ, Zhang ZM, Sutton MS, Keane MG.

Author information

  • 1Medicine, Jesse Brown VA Medical Center and University of Illinois Medical Center, Chicago, USA. fischerm@uic.edu

Abstract

BACKGROUND:

Depressive symptoms are correlated with poor health outcomes in adults with chronic kidney disease (CKD). The prevalence, severity, and treatment of depressive symptoms and potential risk factors, including level of kidney function, in diverse populations with CKD have not been well studied.

STUDY DESIGN:

Cross-sectional analysis.

SETTINGS & PARTICIPANTS:

Participants at enrollment into the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC (H-CRIC) Studies. CRIC enrolled Hispanics and non-Hispanics at 7 centers in 2003-2007, and H-CRIC enrolled Hispanics at the University of Illinois in 2005-2008.

MEASUREMENT:

Depressive symptoms measured by Beck Depression Inventory (BDI).

PREDICTORS:

Demographic and clinical factors.

OUTCOMES:

Elevated depressive symptoms (BDI score ≥11) and antidepressant medication use.

RESULTS:

Of 3,853 participants, 27.4% had evidence of elevated depressive symptoms and 18.2% were using antidepressant medications; 31.0% of persons with elevated depressive symptoms were using antidepressants. The prevalence of elevated depressive symptoms varied by level of kidney function: 23.6% for participants with estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m(2) and 33.8% of those with eGFR <30 mL/min/1.73 m(2). Lower eGFR (OR per 10-mL/min/1.73 m(2) decrease, 1.10; 95% CI, 1.04-1.17), and non-Hispanic black race (OR, 1.42; 95% CI, 1.16-1.74) were each associated with increased odds of elevated depressive symptoms after controlling for other factors. In regression analyses incorporating BDI score, whereas female sex was associated with greater odds of antidepressant use, Hispanic ethnicity, non-Hispanic black race, and higher urine albumin levels were associated with decreased odds of antidepressant use (P < 0.05 for each).

LIMITATIONS:

Absence of clinical diagnosis of depression and use of nonpharmacologic treatments.

CONCLUSIONS:

Although elevated depressive symptoms were common in individuals with CKD, use of antidepressant medications is low. Individuals of racial and ethnic minority background and with more advanced CKD had a greater burden of elevated depressive symptoms and lower use of antidepressant medications.

Published by Elsevier Inc.

PMID:
22497791
[PubMed - indexed for MEDLINE]
PMCID:
PMC3378778
Free PMC Article

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