Skip to main content
SpringerLink
Log in

Depression and its associated factors in pediatric chronic kidney disease

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

Few studies on the occurrence of depression in pediatric patients with chronic kidney disease (CKD) have been conducted and none have identified associated clinical and demographic factors.

Methods

This was a cross-sectional study in which we administered the Child Depression Inventory-2 (CDI-2) to 44 patients aged 9–18 years with CKD stages III–V. Criteria for depression were CDI-2 scores of ≥65 or an established diagnosis of depression recorded in the medical chart. Relative risks (RR) and 95 % confidence intervals (CI) were calculated to determine associations between patient characteristics and depression status.

Results

Of the 44 patients enrolled in the study, 13 (30 %) met our criteria for depression, representing 18 % of patients aged <13 years and 34 % of those aged ≥13 years. Although not reaching statistical significance, the adjusted risk of depression was lower for patients with CKD duration of ≤3 years than for those with longer CKD duration (RR 0.19, 95 % CI 0.02, 1.53), and for those with CKD stage IV (RR 0.23, 95 % CI 0.05, 1.09) and CKD stage V (RR 0.13, 95 % CI 0.01, 1.07) compared to those with CKD stage III.

Conclusions

Our results indicate that depression is common in children with CKD, particularly for those with longstanding renal disease and at CKD stage III.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Stam H, Hartman EE, Deurloo JA, Groothoff J, Grootenhuis MA (2006) Young adult patients with a history of pediatric disease: impact on course of life and transition into adulthood. J Adolesc Health 39:4–13

    Article  PubMed  Google Scholar 

  2. Garralda ME, Jameson RA, Reynolds JM, Postlethwaite RJ (1988) Psychiatric adjustment in children with chronic renal failure. J Child Psychol Psychiatry 29:79–90

    Article  PubMed  CAS  Google Scholar 

  3. Hernandez EG, Loza R, Vargas H, Jara MF (2011) Depressive symptomatology in children and adolescents with chronic renal insufficiency undergoing chronic dialysis. Int J Nephrol 2011:798692

    PubMed  Google Scholar 

  4. Bakr A, Amr M, Sarhan A, Hammad A, Ragab M, El-Refaey A, El-Mougy A (2007) Psychiatric disorders in children with chronic renal failure. Pediatr Nephrol 22:128–131

    Article  PubMed  Google Scholar 

  5. Berney-Martinet S, Key F, Bell L, Lepine S, Clermont MJ, Fombonne E (2009) Psychological profile of adolescents with a kidney transplant. Pediatr Transplant 13:701–710

    Article  PubMed  Google Scholar 

  6. Fukunishi I, Kudo H (1995) Psychiatric problems of pediatric end-stage renal failure. Gen Hosp Psychiatry 17:32–36

    Article  PubMed  CAS  Google Scholar 

  7. Eisenhauer GL, Arnold WC, Livingston RL (1988) Identifying psychiatric disorders in children with renal disease. South Med J 81:572–576

    Article  PubMed  CAS  Google Scholar 

  8. Kessler RC, Avenevoli S, Ries Merikangas K (2001) Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry 49:1002–1014

    Article  PubMed  CAS  Google Scholar 

  9. Hood KK, Huestis S, Maher A, Butler D, Volkening L, Laffel LM (2006) Depressive symptoms in children and adolescents with type 1 diabetes: association with diabetes-specific characteristics. Diabetes Care 29:1389–1391

    Article  PubMed  Google Scholar 

  10. Seigel WM, Golden NH, Gough JW, Lashley MS, Sacker IM (1990) Depression, self-esteem, and life events in adolescents with chronic diseases. J Adolesc Health Care 11:501–504

    Article  PubMed  CAS  Google Scholar 

  11. Burke P, Meyer V, Kocoshis S, Orenstein DM, Chandra R, Nord DJ, Sauer J, Cohen E (1989) Depression and anxiety in pediatric inflammatory bowel disease and cystic fibrosis. J Am Acad Child Adolesc Psychiatry 28:948–951

    Article  PubMed  CAS  Google Scholar 

  12. Ettinger AB, Weisbrot DM, Nolan EE, Gadow KD, Vitale SA, Andriola MR, Lenn NJ, Novak GP, Hermann BP (1998) Symptoms of depression and anxiety in pediatric epilepsy patients. Epilepsia 39:595–599

    Article  PubMed  CAS  Google Scholar 

  13. Hood KK, Rausch JR, Dolan LM (2011) Depressive symptoms predict change in glycemic control in adolescents with type 1 diabetes: rates, magnitude, and moderators of change. Pediatr Diabetes 12:718–723

    Article  PubMed  Google Scholar 

  14. Hedayati SS, Minhajuddin AT, Toto RD, Morris DW, Rush AJ (2009) Prevalence of major depressive episode in CKD. Am J Kidney Dis 54:424–432

    Article  PubMed  Google Scholar 

  15. Drayer RA, Piraino B, Reynolds CF, Houck PR, Mazumdar S, Bernardini J, Shear MK, Rollman BL (2006) Characteristics of depression in hemodialysis patients: symptoms, quality of life and mortality risk. Gen Hosp Psychiatry 28:306–312

    Article  PubMed  Google Scholar 

  16. Young BA, Von Korff M, Heckbert SR, Ludman EJ, Rutter C, Lin EHB, Ciechanowski PS, Oliver M, Williams L, Himmerlfarb J, Katon WJ (2010) Association of major depression and mortality in stage 5 diabetic chronic kidney disease. Gen Hosp Psychiatry 32:119–124

    Article  PubMed  Google Scholar 

  17. Hedayati SS, Minhajuddin AT, Afshar M, Toto RD, Trivedi MH, Rush AJ (2010) Association between major depressive episodes in patients with chronic kidney disease and initiation of dialysis, hospitalization, or death. JAMA 303(19):1946–1953

    Article  PubMed  CAS  Google Scholar 

  18. Kovacs M (2011) Children’s Depression Inventory 2 (CDI-2) 2nd edn, technical manual. Multi-Health Systems, Toronto

    Google Scholar 

  19. Schwartz GJ, Munoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, Furth SL (2009) New equations to estimate GFR in children with CKD. J Am Soc Nephrol 20:629–637

    Article  PubMed  Google Scholar 

  20. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of diet in renal disease study group. Ann Intern Med 130:461–470

    Article  PubMed  CAS  Google Scholar 

  21. Penlower L, Dew MA, Ellis D, Sereika SM, Kitutu JM, Shapiro R (2003) Psychological distress and adherence to the medical regimen among adolescent renal transplant recipients. Am J Transplant 3:1418–1425

    Article  Google Scholar 

  22. Chishold-Burns MA, Spivey CA, Rehfeld R, Zawaideh M, Roe DJ, Gruessner R (2009) Immunosuppressant therapy adherence and graft failure among pediatric renal transplant recipients. Am J Transplant 9:2497–2504

    Article  Google Scholar 

  23. Rao C, Ramu SA, Maiya PP (2011) Depression in adolescents with chronic medical illness. Int J Adolesc Med Health 23:205–208

    Article  PubMed  Google Scholar 

  24. Kovacs M, Goldston D, Obrosky DS, Bonar LK (1997) Psychiatric disorders in youths with IDDM: rates and risk factors. Diabetes Care 20:36–44

    Article  PubMed  CAS  Google Scholar 

  25. Keller MB, Lavori PW, Beardslee WR, Wunder J, Ryan N (1991) Depression in children and adolescents: new data on ‘undertreatment’ and a literature review on the efficacy of available treatment. J Affect Disord 21:163–171

    Article  PubMed  CAS  Google Scholar 

  26. Libby AM, Brent DA, Morrato EH, Orton HD, Allen R, Valuck RJ (2007) Decline in treatment of pediatric depression after FDA advisory on risk of suicidality with SSRIs. Am J Psychiatry 164:884–891

    Article  PubMed  Google Scholar 

  27. American Psychiatric Association Staff (2000) Diagnostic and statistical manual of mental disorders, 3rd edn (DSM-IV-TR). American Psychiatric Association, Arlington

Download references

Acknowledgments

This work was supported by Institutional NIH grant T32 DK007662-20 and Seattle Children’s Center for Clinical and Translational Research Faculty Research grant UL 1 RR025014.

Author information

Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, 622 West 168th Street, PH 17-102B, New York, NY, 10032, USA

    Amy J. Kogon

  2. Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA

    Ann Vander Stoep & Noel S. Weiss

  3. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA

    Ann Vander Stoep & Elizabeth McCauley

  4. Department of Pediatrics, Seattle Children’s Hospital, University of Washington School of Medicine, Seattle, WA, USA

    Jodi Smith & Joseph T. Flynn

Authors
  1. Amy J. Kogon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ann Vander Stoep
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Noel S. Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jodi Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joseph T. Flynn
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Elizabeth McCauley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amy J. Kogon.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kogon, A.J., Vander Stoep, A., Weiss, N.S. et al. Depression and its associated factors in pediatric chronic kidney disease. Pediatr Nephrol 28, 1855–1861 (2013). https://doi.org/10.1007/s00467-013-2497-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-013-2497-5

Keywords

Search

Navigation