S-495 Depression and Suicidal Ideation is Associated with Renal Function in Predialysis CKD Patients = S-495 Depression and Suicidal Ideation is Associated with Renal Function in Predialysis CKD Patients

다국어 초록 (Multilingual Abstract)

Background: Depression areprevalent mental health problemsin patients with ESRD. In addition to socioeconomic factors uremia related factors such as accumulation of indoxyl sulfate and increased oxidative stress have been suggested as causes of this increased prevalence in ESRD patients. Although uremic toxicity and oxidative stress are known to be increased even in early chronic kidney disease patients, the relationship between depression and renal function is not well elucidated. Therefore, the association between renal function and depressive symptoms including suicidal ideation was investigated in predialysis patients with CKD. Methods: Subjects who participated in the Korea National Health and Nutritional Examination Survey from 2010 to 2014 were evaluated. Estimated glomerular filtration rate was calculated using the CKD Modification of Diet in Renal Disease equation. Depression was screened using the Korean version of the World Health Organization Composite International Diagnostic Interview-Short Form. Results: A total of 21,250 subjects were evaluated.The mean age of the subjects was 49 years and 43.9% were male.The mean eGFR of the subjects was 93.2 ml/min/1.73m2. Suicidal ideation was found in 2518 (11.8%) patients, and 5235 (24.6%) patients had depressive symptoms. All of the patients that had suicidal ideation were depressive and 48.1% of the patients with depressive symptoms had suicidal ideations. Suicidal ideation was reported in 101 (11.5%), 86 (12.9%),63 (18.4%), and 6 (33.3%) of each CKD stage 1,2,3 and 4 respectively (P for trend ＜0.001).Depressive symptomswere reported in 193(21.9%),170(25.4%), 111(32.5%), and 8(44.4%)of each CKD stage 1,2,3 and 4 respectively (P for trend 0.002). When the relationship between renal function and mental health problems was evaluated, lower eGFR showed a significant relationship with having suicidal ideation (odds ratio 0.95,95% confidential interval 0.97-0.99, p＝0.02) even after adjustments were made for confounding factors. Conclusions: Depressive symptoms and suicidal ideation weresignificantly more common in higher CKD stage patients. Evaluation and management strategies for mental health issues should be considered in predialysis CKD patients.