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Association between depression and death in people with CKD: a meta-analysis of cohort studies.
Am J Kidney Dis. 2013 Sep; 62(3):493-505.AJ

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.

Links

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Authors+Show Affiliations

Palmer SC
Department of Medicine, University of Otago Christchurch, New Zealand.
Vecchio M
No affiliation info available
Craig JC
No affiliation info available
Tonelli M
No affiliation info available
Johnson DW
No affiliation info available
Nicolucci A
No affiliation info available
Pellegrini F
No affiliation info available
Saglimbene V
No affiliation info available
Logroscino G
No affiliation info available
Hedayati SS
No affiliation info available
Strippoli GF
No affiliation info available

MeSH

Cohort StudiesDepressionHumansMortalityRandomized Controlled Trials as TopicRenal DialysisRenal Insufficiency, Chronic

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

Language

eng

PubMed ID

23623139

Citation

Palmer, Suetonia C., et al. "Association Between Depression and Death in People With CKD: a Meta-analysis of Cohort Studies." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 62, no. 3, 2013, pp. 493-505.
Palmer SC, Vecchio M, Craig JC, et al. Association between depression and death in people with CKD: a meta-analysis of cohort studies. Am J Kidney Dis. 2013;62(3):493-505.
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. (2013). Association between depression and death in people with CKD: a meta-analysis of cohort studies. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 62(3), 493-505. https://doi.org/10.1053/j.ajkd.2013.02.369
Palmer SC, et al. Association Between Depression and Death in People With CKD: a Meta-analysis of Cohort Studies. Am J Kidney Dis. 2013;62(3):493-505. PubMed PMID: 23623139.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between depression and death in people with CKD: a meta-analysis of cohort studies. AU - Palmer,Suetonia C, AU - Vecchio,Mariacristina, AU - Craig,Jonathan C, AU - Tonelli,Marcello, AU - Johnson,David W, AU - Nicolucci,Antonio, AU - Pellegrini,Fabio, AU - Saglimbene,Valeria, AU - Logroscino,Giancarlo, AU - Hedayati,S Susan, AU - Strippoli,Giovanni F M, Y1 - 2013/04/25/ PY - 2012/10/10/received PY - 2013/02/26/accepted PY - 2013/4/30/entrez PY - 2013/4/30/pubmed PY - 2013/11/20/medline KW - Depression KW - dialysis KW - mortality KW - outcomes SP - 493 EP - 505 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 62 IS - 3 N2 - 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. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/23623139/Association_between_depression_and_death_in_people_with_CKD:_a_meta_analysis_of_cohort_studies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(13)00589-1 DB - PRIME DP - Unbound Medicine ER -