title: Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies.
abstract: Prevalence estimates of depression in chronic kidney disease (CKD) vary widely in existing studies. We conducted a systematic review and meta-analysis of observational studies to summarize the point prevalence of depressive symptoms in adults with CKD. We searched MEDLINE and Embase (through January 2012). Random-effects meta-analysis was used to estimate the prevalence of depressive symptoms. We also limited the analyses to studies using clinical interview and prespecified criteria for diagnosis. We included 249 populations (55,982 participants). Estimated prevalence of depression varied by stage of CKD and the tools used for diagnosis. Prevalence of interview-based depression in CKD stage 5D was 22.8% (confidence interval (CI), 18.6-27.6), but estimates were somewhat less precise for CKD stages 1-5 (21.4% (CI, 11.1-37.2)) and for kidney transplant recipients (25.7% (12.8-44.9)). Using self- or clinician-administered rating scales, the prevalence of depressive symptoms for CKD stage 5D was higher (39.3% (CI, 36.8-42.0)) relative to CKD stages 1-5 (26.5% (CI, 18.5-36.5)) and transplant recipients (26.6% (CI, 20.9-33.1)) and suggested that self-report scales may overestimate the presence of depression, particularly in the dialysis setting. Thus, interview-defined depression affects approximately one-quarter of adults with CKD. Given the potential prevalence of depression in the setting of CKD, randomized trials to evaluate effects of interventions for depression on patient-centered outcomes are needed.
authors.affiliation: Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand.
authors.forename: Suetonia
authors.initials: S
authors.lastname: Palmer
authors.forename: Mariacristina
authors.initials: M
authors.lastname: Vecchio
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
authors.forename: Marcello
authors.initials: M
authors.lastname: Tonelli
authors.forename: David W
authors.initials: DW
authors.lastname: Johnson
authors.forename: Antonio
authors.initials: A
authors.lastname: Nicolucci
authors.forename: Fabio
authors.initials: F
authors.lastname: Pellegrini
authors.forename: Valeria
authors.initials: V
authors.lastname: Saglimbene
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Logroscino
authors.forename: Steven
authors.initials: S
authors.lastname: Fishbane
authors.forename: Giovanni F M
authors.initials: GF
authors.lastname: Strippoli
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064887:Observational Studies as Topic; D015995:Prevalence; D011379:Prognosis; D011788:Quality of Life; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012720:Severity of Illness Index