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American Journal of the Medical Sciences:
doi: 10.1097/MAJ.0b013e3182113d9e
Clinical Investigation

Depression, Screening and Quality of Life in Chronic Kidney Disease

Gyamlani, Geeta MD; Basu, Anita MD; Geraci, Stephen MD; Lee, Frederick MD; Moxey, Monique BSN, RN; Clark, Molly PhD; Dubbert, Patricia M. PhD

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Abstract

Introduction: To determine the prevalence of positive screens for depression and to assess quality of life (QoL) and usefulness of the brief and easily administered Patient Health Questionnaire-2 (PHQ-2) for depression screening in the chronic kidney disease (CKD) population; and to explore the relationship between depressive symptoms and markers of inflammation.

Methods: Seventy-one adult patients with estimated glomerular filtration rate <60 mL/min/1.73 m2 or proteinuria, but not on dialysis, were enrolled. QoL was assessed using the Short Form-36. The Center for Epidemiological Studies Depression Scale (CES-D) and PHQ-2 were used to screen for depression. Serum ferritin, albumin, C-reactive protein and hematocrit were also measured as markers of inflammation.

Results: The PHQ-2 and CES-D were significantly correlated (P < 0.05). Positive scores on the CES-D or PHQ-2 had significantly lower Short Form-36 scores. Mean hemoglobin values were significantly lower in patients who screened positive for depression either by CES-D (12.2 ± 1.7 versus 13.2 ± 1.7, P < 0.05) or by PHQ-2 (12 ± 1.6 versus 13.4 ± 1.6, P < 0.01). Neither PHQ-2 nor CES-D correlated with other markers of inflammation in this sample.

Conclusion: Both the CES-D and the PHQ-2 can identify patients with CKD who need further evaluation for depression. The PHQ-2 seems to be a useful screen for depression and impaired QoL in a renal clinic setting. Patients with CKD and lower hemoglobin may be at greater risk for depression than those with normal values.

© Copyright 2011 Southern Society for Clinical Investigation

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