Frailty as an Independent Risk Factor for Depression in Patients With End-Stage Renal Disease: A Cross-Sectional Study

Frontiers in Medicine

article

Chun-Yi Chi¹  Szu-Ying Lee¹  Chia-Ter Chao²  Jenq-Wen Huang¹ 

[1] Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch;Nephrology Division, Department of Internal Medicine, National Taiwan University Hospital;Graduate Institute of Toxicology, National Taiwan University College of Medicine;Nephrology Division, Department of Internal Medicine, National Taiwan University College of Medicine

关键词: chronic kidney disease;    depression;    end-stage renal disease;    frailty;    geriatric phenotype;    malnutrition;    sarcopenia;   

DOI  :  10.3389/fmed.2022.799544

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Depression confers substantial disease burden globally, especially among those with chronic kidney disease (CKD). The presence of depression significantly impairs one's quality of life. Risk factors for depression in patients with CKD remain under-appreciated, and whether frailty, a geriatric phenotype, constitutes a risk factor for depression in this population is unknown. Methods We prospectively enrolled patients with end-stage renal disease (ESRD) undergoing hemodialysis for >3 months from National Taiwan University Hospital Yunlin Branch between 2019 and 2021. Clinical, physical, functional, and performance parameters were recorded, followed by frailty/sarcopenia assessment. Depression was screened for using the Geriatric Depression Scale. We analyzed the independent relationship between frailty and depression in these patients, using multiple regression analyses. Results Totally 151 patients with ESRD were enrolled (mean 61.1 years, 66.9% male), among whom 16.6% had screening-identified depression. ESRD participants with depression did not differ from those without regarding most parameters except serum creatinine, functional indices, and sarcopenia/frailty status. We found that having greater frail severities was independently associated with a higher probability of depression; having FRAIL- (odds ratio [OR] 5.418) and SOF-based (OR 2.858) frailty independently correlated with a higher depression probability. A linear relation exists between a greater frail severity and the probability of depression. Using a more relaxed criterion for detecting depression, higher SOF scores remained significantly associated with an increased depression risk. Conclusions In patients with CKD, frailty independently correlated with a higher probability of having depression. Strategies aiming to attenuate frailty may be able to benefit those with depression simultaneously in this population.

【 授权许可】

CC BY