Depression and incident cardiovascular disease among patients with chronic kidney disease

Anthony D'Oro, Devansh Himanshu Patel, Sojin Wass, Trygve Dolber, Khurram Nasir, Mirela Dobre, Mahboob Rahman, Sadeer Al-Kindi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Depression is associated with an increased risk of cardiovascular disease (CVD) and is prevalent among patients with chronic kidney disease (CKD). We aimed to identify the association of depression with incident CVD. Methods: We studied patients with CKD stages 2–4 enrolled in the Chronic Renal Insufficiency Cohort (CRIC) and excluded participants with preexisting CVD. The Cox proportional hazard model was used to examine the association between baseline depression [Beck's Depression Inventory (BDI) score ≥11] and incidence of CVD (cerebrovascular accident, myocardial infarction, heart failure, or peripheral artery disease). Models were adjusted for age, sex, race, estimated glomerular filtration rate (eGFR), urine albumin-creatinine ratio (UACR), systolic and diastolic blood pressure, and 10-year estimated CVD risk. Results: Among 2585 CRIC study participants, 640 (25%) patients had depression at study baseline. Compared to patients without depression, patients with depression were more likely to be women (56% vs. 46%), non-White (68% vs. 53%), with household income <$20,000 (53% vs. 26%), without a high school degree (31% vs. 15%), uninsured (13% vs. 7%), with lower eGFR (42 vs. 46 ml/min/1.73 m (Palmer et al., 2013 Jul)22), and with higher UACR (90 vs. 33 mg/g). In multivariate analyses, depression was associated with a 29% increased risk of developing CVD (adjusted hazard ratio 1.29, 95% confidence interval 1.03–1.62, p = 0.03). BDI (as a continuous variable) was associated with CVD (adjusted hazard ratio 1.017, 95% confidence interval 1.004–1.030, p = 0.012). Conclusions: Among patients with CKD stages 2–4 enrolled in CRIC without preexisting CVD, depression was associated with a 29% increased risk of incident CVD.

Original languageEnglish (US)
Article number200199
JournalInternational Journal of Cardiology: Cardiovascular Risk and Prevention
Volume18
DOIs
StatePublished - Sep 2023

Keywords

  • Cardiovascular risk
  • Psychosocial risk factors

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

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