Diabetes self-care, major depression, and chronic kidney disease in an outpatient diabetic population.

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  • Author(s): Yu MK;Yu MK; Katon W; Young BA
  • Source:
    Nephron. Clinical practice [Nephron Clin Pract] 2013; Vol. 124 (1-2), pp. 106-12. Date of Electronic Publication: 2013 Oct 29.
  • Publication Type:
    Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Karger Country of Publication: Switzerland NLM ID: 101159763 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1660-2110 (Electronic) Linking ISSN: 16602110 NLM ISO Abbreviation: Nephron Clin Pract Subsets: MEDLINE
    • Publication Information:
      Original Publication: Basel : Karger, c2003-
    • Subject Terms:
      Albuminuria/*epidemiology ; Ambulatory Care/*statistics & numerical data ; Depressive Disorder, Major/*epidemiology ; Diabetes Complications/*epidemiology ; Diabetes Complications/*therapy ; Renal Insufficiency, Chronic/*epidemiology ; Self Care/*statistics & numerical data; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Renal Insufficiency, Chronic/therapy ; Risk Factors ; Treatment Outcome
    • Abstract:
      Background/aims: The associations between major depression and chronic kidney disease (CKD) in patients with diabetes are incompletely characterized. Depressed patients with diabetes are known to have worse diabetes self-care, but it is not known whether this mediates the association between depression and CKD in this population.
      Methods: We conducted a cross-sectional study of the associations between major depressive symptoms and CKD in the Pathways Study (n = 4,082), an observational cohort of ambulatory diabetic patients from a managed care setting. Depression status was ascertained using the Patient Health Questionnaire-9 (PHQ-9). Stepwise logistic regression models examined the associations between depression and impaired estimated glomerular filtration rate (<60 ml/min/1.73 m(2)) or microalbuminuria, after adjustment for demographics, CKD risk factors, and diabetes self-care variables.
      Results: Clinically significant depression symptoms (PHQ-9 ≥10) were associated with a greater risk of microalbuminuria after adjustment for demographic variables (OR 1.54, 95% CI 1.21-1.95) and traditional CKD risk factors (OR 1.36, 95% CI 1.04-1.77); this association persisted after additional adjustment for diabetes self-care (OR 1.34, 95% CI 1.02-1.75). Depression was not associated with impaired estimated glomerular filtration rate in any of the models.
      Conclusion: In this cohort of diabetic subjects, clinically significant depression symptoms were associated with microalbuminuria, which could not be entirely explained by differences in diabetes self-care.
      (© 2013 S. Karger AG, Basel.)
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    • Grant Information:
      R01 MH041739 United States MH NIMH NIH HHS; MH01643 United States MH NIMH NIH HHS; MH41739 United States MH NIMH NIH HHS; R01 DK079745 United States DK NIDDK NIH HHS; K02 MH001643 United States MH NIMH NIH HHS; R01 DK 079745 United States DK NIDDK NIH HHS; T32 DK007467 United States DK NIDDK NIH HHS
    • Publication Date:
      Date Created: 20131107 Date Completed: 20140808 Latest Revision: 20220317
    • Publication Date:
      20240628
    • Accession Number:
      PMC3897267
    • Accession Number:
      10.1159/000355551
    • Accession Number:
      24192760