International Urology and Nephrology

, Volume 42, Issue 4, pp 1063–1068 | Cite as

Depressive symptoms and chronic kidney disease: results from the National Health and Nutrition Examination Survey (NHANES) 2005–2006

  • Ana C. Ricardo
  • Michael J. Fischer
  • Andrew Peck
  • Mary Turyk
  • James P. Lash
Nephrology - Original Paper


Background and objective

Depression is common in individuals with end-stage renal disease. However, its relationship with earlier stages of chronic kidney disease (CKD) is less well known. In this study, we examined the association between depressive symptoms and CKD.


Cross-sectional analysis of the prevalence and correlates of depressive symptoms were measured by the Patient Health Questionnaire (PHQ-9) among adult participants with CKD in the National Health and Nutrition Examination Survey 2005–2006. CKD was defined according to estimated glomerular filtration rate by Modification of Diet in Renal Disease Study equation of <60 ml/min/1.73 m2 or the presence of microalbuminuria (≥30 mg/g creatinine), using the Kidney Disease Outcomes Quality Initiative classification. A PHQ-9 score ≥ 10 was considered to be indicative of depressive symptoms.


Among 3653 subjects in our study sample, 683 (15.2%) met laboratory criteria for CKD. The prevalence of depressive symptoms was 7% (95% confidence interval [CI] 3.2–10.8%) in subjects with CKD and 6% (95% CI 4.6–7.4%) in subjects without CKD (P = 0.6). In regression analysis, the presence of CKD was not significantly associated with depressive symptoms (adjusted odds ratio = 0.96 [95% CI 0.51, 1.78], P = 0.9).


We found no difference in the prevalence of depressive symptoms among individuals with or without CKD.


Chronic kidney disease Depression National Health and Nutrition Examination Survey Prevalence 



The abstract of this manuscript was presented at the 2009 Scientific Meetings of the National Kidney Foundation in Nashville, TN. Ana C. Ricardo: Research support: University of Illinois at Chicago (UIC) Center for Clinical and Translational Science (CCTS), Award Number UL1RR029879 from the National Center for Research Resources. Financial disclosure: none. Michael J. Fischer: VA HSR&D Career Development Award. Financial disclosure: none. Andrew Peck, Mary Turyk, James P. Lash: none.


  1. 1.
    Kimmel PL, Peterson RA, Weihs KL, Simmens SJ, Alleyne S, Cruz I, Veis JH (1998) Psychosocial factors, behavioral compliance and survival in urban hemodialysis patients. Kidney Int 54:245–254CrossRefPubMedGoogle Scholar
  2. 2.
    Andrade CP, Cruz MC, Urrutia M, Pereira O, Draibe SA, Nogueira-Martins LA, Sesso R (2010) Evaluation of depressive symptoms in patients with chronic renal failure. J Nephrol 23:168–174PubMedGoogle Scholar
  3. 3.
    Hedayati SS, Bosworth HB, Kuchibhatla M, Kimmel PL, Szczech LA (2006) The predictive value of self-report scales compared with physician diagnosis of depression in hemodialysis patients. Kidney Int 69:1662–1668CrossRefPubMedGoogle Scholar
  4. 4.
    Lopes AA, Albert JM, Young EW, Satayathum S, Pisoni RL, Andreucci VE, Mapes DL, Mason NA, Fukuhara S, Wikstrom B, Saito A, Port FK (2004) Screening for depression in hemodialysis patients: associations with diagnosis, treatment, and outcomes in the DOPPS. Kidney Int 66:2047–2053CrossRefPubMedGoogle Scholar
  5. 5.
    Novak M, Molnar MZ, Szeifert L, Kovacs AZ, Vamos EP, Zoller R, Keszei A, Mucsi I (2010) Depressive symptoms and mortality in patients after kidney transplantation: a prospective prevalent cohort study. Psychosom MedGoogle Scholar
  6. 6.
    Watnick S, Wang PL, Demadura T, Ganzini L (2005) Validation of 2 depression screening tools in dialysis patients. Am J Kidney Dis 46:919–924CrossRefPubMedGoogle Scholar
  7. 7.
    Kutner NG (2008) Promoting functioning and well-being in older CKD patients: review of recent evidence. Int Urol Nephrol 40:1151–1158CrossRefPubMedGoogle Scholar
  8. 8.
    Hedayati SS, Minhajuddin AT, Toto RD, Morris DW, Rush AJ (2009) Prevalence of major depressive episode in CKD. Am J Kidney Dis 54:424–432CrossRefPubMedGoogle Scholar
  9. 9.
    Hedayati SS, Jiang W, O’Connor CM, Kuchibhatla M, Krishnan KR, Cuffe MS, Blazing MA, Szczech LA (2004) The association between depression and chronic kidney disease and mortality among patients hospitalized with congestive heart failure. Am J Kidney Dis 44:207–215CrossRefPubMedGoogle Scholar
  10. 10.
    Odden MC, Whooley MA, Shlipak MG (2006) Depression, stress, and quality of life in persons with chronic kidney disease: the Heart and Soul Study. Nephron Clin Pract 103:c1–c7CrossRefPubMedGoogle Scholar
  11. 11.
    Cohen SD, Patel SS, Khetpal P, Peterson RA, Kimmel PL (2007) Pain, sleep disturbance, and quality of life in patients with chronic kidney disease. Clin J Am Soc Nephrol 2:919–925CrossRefPubMedGoogle Scholar
  12. 12.
    McClellan WM, Abramson J, Newsome B, Temple E, Wadley VG, Audhya P, McClure LA, Howard VJ, Warnock DG, Kimmel P (2010) Physical and psychological burden of chronic kidney disease among older adults. Am J Nephrol 31:309–317CrossRefPubMedGoogle Scholar
  13. 13.
    National Center for Health Statistics (2008) National Health and Nutrition Examination Survey (NHANES) analytic guidelines. Accessed 20 Nov 2008
  14. 14.
    National Center for Health Statistics (2008) National Health and Nutrition Examination Survey 2005–2006. Documentation, codebook, and frequencies. Standard Biochemistry Profile. Accessed 11 Nov 2008
  15. 15.
    Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16:606–613CrossRefPubMedGoogle Scholar
  16. 16.
    National Kidney Foundation (2002) K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis 39(suppl 1):S1–S266Google Scholar
  17. 17.
    Abdel-Kader K, Unruh ML, Weisbord SD (2009) Symptom burden, depression, and quality of life in chronic and end-stage kidney disease. Clin J Am Soc Nephrol 4:1057–1064CrossRefPubMedGoogle Scholar
  18. 18.
    Watnick S, Kirwin P, Mahnensmith R, Concato J (2003) The prevalence and treatment of depression among patients starting dialysis. Am J Kidney Dis 41:105–110CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, B.V. 2010

Authors and Affiliations

  • Ana C. Ricardo
    • 1
  • Michael J. Fischer
    • 1
    • 2
    • 3
  • Andrew Peck
    • 1
  • Mary Turyk
    • 4
  • James P. Lash
    • 1
  1. 1.Medicine/NephrologyUniversity of IllinoisChicagoUSA
  2. 2.Medicine/NephrologyJesse Brown VA Medical CenterChicagoUSA
  3. 3.Center for the Management of Complex Chronic CareHines VA HospitalHinesUSA
  4. 4.Division of Epidemiology and Biostatistics, School of Public HealthUniversity of Illinois at ChicagoChicagoUSA

Personalised recommendations