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Depression and chronic kidney disease: A review for clinicians

Alison Bautovich1, Ivor Katz2, Michelle Smith3

  • 1School of Psychiatry, University of New South Wales, Sydney, Australia NSW Institute of Psychiatry, Westmead, Australia St George Hospital, Kogarah, Australia a.bautovich@unsw.edu.au.

The Australian and New Zealand Journal of Psychiatry
|March 25, 2014
PubMed

Insights

Depression is prevalent in chronic kidney disease (CKD), affecting about 20% of patients and leading to poorer health outcomes. Further research is needed to establish effective treatments for depression in CKD patients.

Area of Science:

  • Nephrology
  • Psychiatry
  • Clinical Medicine

Background:

  • Depression is a significant comorbidity in patients with chronic kidney disease (CKD).
  • The prevalence, causes, and consequences of depression in CKD are complex and multifactorial.
  • Existing literature highlights the adverse impact of depression on CKD patient outcomes.

Purpose of the Study:

  • To synthesize recent literature on depression in CKD, covering prevalence, etiology, associations, and management.
  • To offer clinicians a practical and current resource for managing depression in CKD patients.
  • To identify gaps in current research and guide future clinical practice.

Main Methods:

  • Comprehensive literature search of MEDLINE, EMBASE, and PsycINFO databases.
  • Utilized search terms including "depression," "mood disorders," and "mental illness" combined with "kidney disease," "renal insufficiency," "dialysis," and "kidney failure."
  • Specific searches were conducted for studies on antidepressant use in CKD.

Main Results:

  • Recent studies confirm significantly elevated depression rates in CKD patients, with meta-analyses indicating approximately 20% prevalence.
  • Depression in CKD is linked to adverse outcomes such as increased mortality, hospitalization, reduced treatment adherence, and lower quality of life.
  • While clinical assessment can be challenging, various treatment options are available once depression is diagnosed.

Conclusions:

  • Depression is a common and serious condition in individuals with CKD, associated with substantial risks.
  • There is an urgent need for rigorous randomized controlled trials to evaluate interventions for depression in CKD.
  • Such trials are crucial for determining the safety and efficacy of treatments, improving patient care.
Abstract

Keywords:
Antidepressive agentsdepressiondialysiskidney diseasemental illnessrenal failure

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