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Association Between Serum Uric Acid and Depression in Patients with Chronic Kidney Disease not Requiring Kidney Dialysis: Cross-Sectional and Longitudinal Analyses

Bin Gao, Xinyuan Song, Jie Hao, Yingying Han, Miaomiao Zhang, Na Sun, Jinping Li, Pingping Qi, Shunya Uchida, Wenxiu Chang

Department of Nephrology, Tianjin First Center Hospital, Tianjin, China (mainland)

Med Sci Monit 2020; 26:e925386

DOI: 10.12659/MSM.925386

Available online: 2020-08-06

Published: 2020-09-27

BACKGROUND: Depression is the main problem of psycho-nephrology. We aimed to investigate clinical risk factors for depression in patients with non-dialysis chronic kidney disease (CKD).
MATERIAL AND METHODS: A non-dialysis CKD cohort study was conducted with 223 patients. Information on demographic and clinical parameters was collected at baseline. Beck Depression Inventory (BDI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires were used to estimate depression and sleep quality in the patients. The questionnaires were repeated in 158 patients after 6 months. Logistic regression was performed to identify independent factors associated with depression and any longitudinal changes in BDI scores.
RESULTS: At baseline, 17 patients (7.72%) in the CKD cohort presented with depression. Multivariate logistic regression revealed that being female (odds ratio [OR] 0.319, 95% confidence interval [CI] 0.108 to 0.944, P=0.039) and having lower levels of serum uric acid (SUA) (OR 0.675, 95% CI 0.469 to 0.970, P=0.034) were independent risk factors for depression. A decrease in PSQI score (OR 0.873, 95% CI 0.777 to 0.981, P=0.022) and an increase in SUA level (OR 1.383, 95% CI 1.115 to 1.715, P=0.003) were independently associated with decline in BDI scores in the patients in the 6-month follow-up group.
CONCLUSIONS: Lower SUA levels and being female were independent risk factors for depression in non-dialysis CKD patients. Improving sleep quality and increasing SUA levels may relieve depression to some extent.

Keywords: Depressive Disorder, Quality of Life, Renal Insufficiency, Chronic, Uric Acid