Sociodemographic factors contribute to the depressive affect among African Americans with chronic kidney disease.
Depression is common in end-stage renal disease and is associated with poor quality of life and higher mortality; however, little is known about depressive affect in earlier stages of chronic kidney disease. To measure this in a risk group burdened with hypertension and kidney disease, we conducted a cross-sectional analysis of individuals at enrollment in the African American Study of Kidney Disease and Hypertension Cohort Study. Depressive affect was assessed by the Beck Depression Inventory II and quality of life by the Medical Outcomes Study-Short Form and the Satisfaction with Life Scale. Beck Depression scores over 14 were deemed consistent with an increased depressive affect and linear regression analysis was used to identify factors associated with these scores. Among 628 subjects, 166 had scores over 14 but only 34 were prescribed antidepressants. The mean Beck Depression score of 11.0 varied with the estimated glomerular filtration rate (eGFR) from 10.7 (eGFR 50-60) to 16.0 (eGFR stage 5); however, there was no significant independent association between these. Unemployment, low income, and lower quality and satisfaction with life scale scores were independently and significantly associated with a higher Beck Depression score. Thus, our study shows that an increased depressive affect is highly prevalent in African Americans with chronic kidney disease, is infrequently treated with antidepressants, and is associated with poorer quality of life. Sociodemographic factors have especially strong associations with this increased depressive affect. Because this study was conducted in an African-American cohort, its findings may not be generalized to other ethnic groups.
Fischer
Michael J
MJ
Department of Medicine, Jesse Brown VA Medical Center and University of Illinois Medical Center, Chicago, Illinois, USA. fischerm@uic.edu
Kimmel
Paul L
PL
Greene
Tom
T
Gassman
Jennifer J
JJ
Wang
Xuelei
X
Brooks
Deborah H
DH
Charleston
Jeanne
J
Dowie
Donna
D
Thornley-Brown
Denyse
D
Cooper
Lisa A
LA
Bruce
Marino A
MA
Kusek
John W
JW
Norris
Keith C
KC
Lash
James P
JP
D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology*; D011307:Drug Prescriptions; D004651:Employment; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007182:Income; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000208:ethnology* / Q000503:physiopathology / Q000523:psychology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D000928:Antidepressive Agents