Association of depressive symptom trajectories with chronic kidney disease in middle-aged and older adults

Longyang Han; Yiqun Li; Minglan Jiang; Xiao Ren; Wenyan Wu; Xiaowei Zheng

doi:10.1016/j.jpsychores.2024.112036

Association of depressive symptom trajectories with chronic kidney disease in middle-aged and older adults

J Psychosom Res. 2025 Jan 3:189:112036. doi: 10.1016/j.jpsychores.2024.112036. Online ahead of print.

Authors

Longyang Han¹, Yiqun Li¹, Minglan Jiang¹, Xiao Ren¹, Wenyan Wu², Xiaowei Zheng³

Affiliations

¹ Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China.
² The Fifth People's Hospital of Wuxi (Wuxi Infectious Disease Hospital), Affiliated Hospital of Jiangnan University, Wuxi, China. Electronic address: 1624894211@qq.com.
³ Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu 214122, China. Electronic address: zxw19921212@163.com.

PMID: 39764944
DOI: 10.1016/j.jpsychores.2024.112036

Abstract

Introduction: This study aimed to investigate the association between trajectories of depressive symptoms and the subsequent risk of chronic kidney disease (CKD) by measuring depressive symptoms repeatedly in older adults with normal renal function.

Methods: A total of 9650 participants, comprising community-dwelling middle-aged and older adults from the China Health and Retirement Longitudinal Study, were included. Depressive symptoms were assessed at three time points: Wave 1 (2011-2012), Wave 2 (2013-2014), and Wave 3 (2015-2016). Trajectories of depressive symptoms were determined using latent mixed models, and the association between these trajectories and CKD was verified using COX proportional hazards models.

Results: Five trajectory patterns of depressive symptoms were identified: low CESD-10 score (Low-Stable, 3702 participants, 38.36 %), moderate CESD-10 score (Moderate-Stable, 3602 participants, 37.33 %), continuously increasing CESD-10 score from moderate initiation (Moderate-Increasing, 825 participants, 8.55 %), continuously decreasing CESD-10 score from high initiation (High-Decreasing, 1032 participants, 10.69 %), and stable high CESD-10 score (High-stable, 489 participants, 5.07 %). During the two-year follow-up period from Wave 3 to Wave 4 (2017-2018), 420 CKD events occurred. Participants in the Moderate-Stable, Moderate-Increasing, High-Decreasing, and High-Stable groups had an increased risk of developing CKD compared to those in the Low-Stable group, with multivariable-adjusted hazard ratios (95 % confidence interval) were 1.32 (1.02-1.71), 1.68 (1.15-2.45), 2.26 (1.63-3.13), and 3.73 (2.57-5.43), respectively, comparted to those with low-stable trajectory.

Conclusion: Middle-aged and older adults with increasing (Moderate-Increasing) and persistent depressive symptoms (including Moderate-Stable, High-Decreasing, and High-Stable) face a higher risk of developing CKD over time.

Keywords: CHARLS; Chronic kidney disease; Depressive symptom trajectories.