Association between depression and death in people with CKD: a meta-analysis of cohort studies
Abstract
Background Depression occurs relatively commonly in people with chronic kidney disease (CKD), but it is uncertain whether depression is a risk factor for premature death in this population. Interventions to reduce mortality in CKD consistently have been ineffective and new strategies are needed.Study design Systematic review and meta-analysis of cohort studies.Setting & population Adults with CKD.Selection criteria for studies Cohort studies identified in Ovid MEDLINE through week 3 December 2012 without language restriction.Predictor Depression status as determined by physician diagnosis, clinical coding, or self-reported scales.Selection criteria for studies All-cause and cardiovascular mortality. Outcomes were summarized as relative risks (RRs) with 95% CIs using random-effects meta-analysis.Results 22 studies (83,381 participants) comprising 12,063 cases of depression (mean prevalence, 27.4%; 95% CI, 20.0%-36.3%) with a follow-up of 3 months to 6.5 years were included. Methodological quality generally was good or fair. Depression consistently increased the risk of death from any cause (RR, 1.59; 95% CI, 1.35-1.87), but had less certain effects on cardiovascular mortality (RR, 1.88; 95% CI, 0.84-4.19). Associations for mortality were similar regardless of the diagnostic method used for depression, but were weaker in analyses controlled for preexisting cardiovascular disease (RR, 1.36; 95% CI, 1.23-1.50).Limitations Meta-analyses adjusting for antidepressant medication use were not possible, and data for kidney transplant recipients and individuals with earlier stages of CKD not treated with dialysis were limited.Conclusions Depression is associated with a substantially increased risk of death in people with CKD. Effective treatment for depression in people with CKD may reduce mortality.
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Depression tied to complications raises mortality.
“Fear of complications is a major component of diabetes distress, and depression associated with complications increases mortality (123,124).”
From Psychosocial care for people with diabetes: a position statement of the American Diabetes Association (2016) · cites this paper as [124]
Fear of complications is a major part of diabetes distress.
“Fear of complications is a major component of diabetes distress, and depression associated with complications increases mortality (123,124).”
From Psychosocial care for people with diabetes: a position statement of the American Diabetes Association (2016) · cites this paper as [124]
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Self-citation
- Authors
- Palmer, S. C., Vecchio, M., Craig, J. C., Tonelli, M., Johnson, D. W., Nicolucci, A., Pellegrini, F., Saglimbene, V., Logroscino, G., Hedayati, S. S., & Strippoli, G. F. M.
- Affiliations
- University of Otago (NZ)
- Mario Negri Sud Foundation (IT)
- The University of Sydney (AU)
- University of Alberta (CA)
- The University of Queensland (AU)
- Casa Sollievo della Sofferenza (IT)
- University of Bari Aldo Moro (IT)
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Strippoli, Giovanni F.M.
- ORCID
- Venue
- American Journal of Kidney Diseases
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 62
- Issue
- 3
- Pages
- 493-505
- ISSN
- 0272-6386 (ISSN-L)
- OpenAlex
- W2133632336
- Cited by
- 201
- References
- 76
- Citations by year
- 2026: 9 · 2025: 22 · 2024: 20 · 2023: 17 · 2022: 18 · 2021: 13 · 2020: 17 · 2019: 20 · 2018: 9 · 2017: 14 · 2016: 14 · 2015: 14 · 2014: 10 · 2013: 2
- FWCI
- 1.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Kidney Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Amgen
- Queensland Health
- Queensland Government
- Topics
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression, chronic kidney disease, mortality, cardiovascular mortality, all-cause mortality, depression as risk factor, depression prevalence, depression treatment
- MeSH terms
- Depression, Renal Dialysis, Humans, Mortality, Cohort Studies, Randomized Controlled Trials as Topic, Renal Insufficiency, Chronic
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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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