Association of renal function and depressive symptoms: Evidence from the China health and retirement longitudinal study

Aim: We examined the association between kidney function and risks of depression in a nationally representative sample of community-dwelling older adults. Methods: Participants were a subset selected from the China Health and Retirement Longitudinal Study. Estimated glomerular filtration rate (eGFR) was calculated using chronic kidney disease epidemiology collaboration equations. Incident depression was defined by a score of 10 or higher on the 10-item Center for Epidemiologic Studies Depression Scale, use of antidepressant medications, or both, at the 2015 follow-up visit. Multiple linear regression analyses were used to examine the baseline eGFR and CESD-10 score during follow up. The associations between level of renal function at baseline and incident depression were assessed using multivariate logistic regression analysis. Results: Over a four-year follow-up period, 22.8% (N = 773) of the participants reported incident depression. After multivariate analysis, baseline eGFRcr and eGFRcr-cys were significantly associated with higher depression score during follow up. Coefficients and 95%CI for eGFRcr and eGFRcr-cys were - 0.041(-0.066 to -0.016) and - 0.028(-0.051 to -0.005), respectively. Using eGFRcr-cys, the crude odds ratio (OR) for incident depression in the 4th quartile group was 1.60 (95%CI 1.23-2.06) than that in the 1st quartile group, (p for trend < 0.001). Fully adjustment for confounding factors did not attenuate but strengthened the association (OR 2.46, 95%CI 1.61-3.76). Conclusions: Among community-dwelling older adults over most of the range in renal function, eGFR was significantly, independently, and associated with incident depression.