Associations between depressive and anxiety symptoms and incident kidney failure in patients with diabetic nephropathy

Abstract Objective This study aimed to analyze the associations between depressive and anxiety symptoms and risk of incident kidney failure in patients with biopsy-proven diabetic nephropathy (DN). Methods This retrospective study enrolled 241 type 2 diabetic patients with biopsy-proven DN. Huaxi Em...

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Main Authors: Chunmei Qin, Yucheng Wu, Yutong Zou, Yuancheng Zhao, Deying Kang, Fang Liu
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-025-03983-x
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Summary:Abstract Objective This study aimed to analyze the associations between depressive and anxiety symptoms and risk of incident kidney failure in patients with biopsy-proven diabetic nephropathy (DN). Methods This retrospective study enrolled 241 type 2 diabetic patients with biopsy-proven DN. Huaxi Emotional-Distress Index (HEI) was used to evaluate the depression and anxiety status of patients on admission. According to the HEI score, DN patients were divided into HEI score ≤ 8 group (without depression and anxiety) and HEI score > 8 group (with depression and anxiety). The study endpoint was defined as progression to kidney failure. The cox proportional hazard analysis was performed to investigate the risk factors for progression to kidney failure in DN patients. Results Twenty-three patients had HEI score > 8, accounting for about 9.5% of all patients. Compared with HEI score ≤ 8 group, those with HEI score > 8 had more severe proteinuria, higher systolic blood pressure, and lower baseline eGFR and serum albumin levels. During a median follow-up of 28 months, the outcome event occurred in 89 (36.9%) of all the patients. After multivariable adjustment, HEI score > 8 (HR 1.825, 95% CI 1.050–3.172) was associated with an increased risk of progression to kidney failure. Conclusion Depressive and anxiety symptoms might be associated with an increased risk of progression to kidney failure in patients with DN, which implied psychosocial issues should be early screened, assessed and intervened to delay the progression of DN.
ISSN:1471-2369