Depression and Diabetes Increases Risk of Kidney Failure


Kidney failure risk could increase for people with diabetes who have major depression in comparison to diabetics without the condition. The findings were published in Clinical Journal of the American Society of Nephrology by lead researcher Margaret Yu and colleagues from the University of Washington.

Just under 3900 diabetic adults who had the disease for a median of under 9 years were followed in the research. The study had the patient’s fill out an exam that determined their level of depression, if at all. Researchers also analyzed the patients’ management of the disease in regards to the amount of exercise, blood sugar monitoring, and diet, along with examining laboratory tests of the function of their kidneys.

To get the full scope, the amount of years the patient had diabetes, on top of their high blood pressure, body fat measurement, education, ethnicity, marital status, age, education, and whether they smoked or not was also put into consideration.

In all, the results showed that those who had symptoms of major depression were also at a higher risk of incidences of chronic kidney disease also known as end-stage renal disease (ESRD). Yu, as reported on Med Page Today, said this risk is up to 85 percent and it is stronger than any other factors measured, such as smoking or obesity.

ESRD is the progressive deterioration of kidney function lasting over months, sometimes years. The National Institute of Diabetes, Digestive and Kidney Disease say that the most common cause for kidney failure is diabetes. More so, according to Medscape chronic kidney disease is the ninth leading cause of death in America.

Yu informs MedPage Today of the well-known fact, at least among her and her colleagues, of how depression is highly prevalent in patients on dialysis. The effect that depression has on people with the kidney disease in its early stages, however, is something that has only begun to be looked at, starting with Yu’s revealing research on how depression and diabetes could increase the risk of kidney failure.

In the study 448 patients had major depression while 327 were diagnosed with minor depression – 87 developed Chronic Kidney Disease. It was also found that major depression was prevalent in younger females who had low levels of salary and education, especially when compared to those participants who did not have symptoms of depression. The only similarities between both groups was how there was a prevalence of type 1 diabetes, dylsipidemia, and hypertension.

In particular ESRD was prevalent in 6.65 years per every 1,000 years of patients with major depression. This number is significantly lower for those with symptoms of minor depression at 4.30 per 1000 patient years, and much lower for those without depression at 2.7.

Yu and colleagues write in the journal that to their knowledge this is the first study to show that there is a link between major depression and long-term risk of ESRD in the U.S. The key word is major, with minor depression not appearing to have any significant impact on risks of kidney disease, according to the study.

Seeing how high the risk of kidney failure can be caused by major depression in diabetics, Yu says that a simple question or two can help with positive change for patients, as opposed to a detailed interview that looks at the full diagnostic. In particular asking a diabetic patient simply on how they are feeling can have, according to Yu, “a pretty good sensitivity and specificity.”

By Kollin Lore


National Institute of Diabetes, Digestive and Kidney Disease
Clinical Journal of the American Society of Nephrology
Med Page Today

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