南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (2): 225-231.doi: 10.12122/j.issn.1673-4254.2023.02.10

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抑郁症状与肾功能快速下降及慢性肾脏病的发生无相关性

杨孟迪，尹鸿涛，甄洁玉，丁雨露，王玉洁，孙琳楠，何风英，甄东户   

  1. 兰州大学第一临床医学院，甘肃 兰州 730030，兰州大学第一医院内分泌科，甘肃 兰州 730030，甘肃省人民医院妇科，甘肃 兰州 730000
  • 出版日期:2023-02-20 发布日期:2023-03-16

Depressive symptoms are not associated with risks of rapid renal function decline or chronic kidney disease in middle-aged and elderly with normal kidney function: a longitudinal investigation

YANG Mengdi, YIN Hongtao, ZHEN Jieyu, DING Yulu, WANG Yujie, SUN Linnan, HE Fengying, ZHEN Donghu   

  1. First Clinical Medical College, Lanzhou University, Lanzhou 730030, China; Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou 730030, China; Department of Gynecology, Gansu Provincial People's Hospital, Lanzhou 730000, China
  • Online:2023-02-20 Published:2023-03-16

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摘要： 目的 探讨肾功能正常的中老年人群基线抑郁症状与肾功能快速下降以及进展为慢性肾脏病风险的相关性。方法 选取2011年开展的“REACTION”研究兰州地区40~75岁eGFR≥60 mL·min-1·1.73m-2且无蛋白尿的居民并于2014年开始随访，对2次调查资料完整并且符合要求的4961例参与者进行研究。根据PHQ-9问卷得分将基线人群分为2组：无抑郁症状和有抑郁症状组。使用Cox回归比较两种抑郁状态下各组的肾功能快速下降以及慢性肾脏病（CKD）发病情况及其相关性。结果（1）PHQ-9得分与基线血清肌酐（SCr）、尿微量白蛋白（ALB）、尿微量白蛋白/肌酐（UACR）以及肾小球滤过率（eGFR）无关；（2）在平均随访3.4±0.6年后，有33.9%基线时有抑郁症状的参与者出现肾功能快速下降，有3.6%进展为CKD；（3）平均随访3.4±0.6年后发现，肾功能快速下降及进展为CKD的发病风险与有无抑郁症无关（P>0.05），即使对抑郁症进行不同分类，也未观察到明显的相关性（均P>0.05）。结论 抑郁症状的有无与普通人肾功能快速下降及进展为CKD的发生无关。

关键词: 抑郁症状；慢性肾病；肾功能下降

Abstract: Objective To explore the association between depressive symptoms and the risks of rapid decline in renal function and chronic kidney disease (CKD) in middle-aged and elderly with normal kidney function. Methods The residents aged 40-75 years with eGFR≥60 mL·min-1·1.73 m-2 without proteinuria in Lanzhou region, who participated in the "REACTION" study carried out in 2011, were selected and followed up in 2014. A total of 4961 individuals with complete and qualified data from the two surveys were included in the subsequent analysis. Based on PHQ-9 questionnaire scores, the baseline population was divided into two groups with and without depressive symptoms. Cox proportional hazard analysis was used to compare the incidences of rapid renal function decline and CKD between the two groups and study the association of depressive symptoms with the risk of these renal conditions. Results PHQ-9 questionnaire scores were not found to correlate with baseline SCr, ALB, UACR or eGFR levels among the participarts (P>0.05). After a mean follow-up time of 3.4±0.6 years, 33.9% of the participants with depressive symptoms at baseline experienced a rapid decline in renal function and 3.6% progressed to CKD. During the follow-up, the incidence of rapid decline in renal function and the risk of developing CKD were not found to correlate with depressive symptoms in these participants (P>0.05) regardless of the type of the depressive syndromes. Conclusion Depressive symptoms are not associated with the risks of rapid renal function decline or progression to CKD in middle-aged and elderly with normal kidney function.

Key words: depressive symptoms; chronic kidney disease; kidney function decline