In the article “Association of Depressive Symptoms with Rapid Kidney Function Decline in Adults with Normal Kidney Function,” found in this issue of CJASN, Zhang et al. evaluated the prospective association between depressive symptoms and rapid kidney function decline (1).
As a two-time kidney transplant recipient with an American-born Chinese background and extensive experience in health care and social services, I would like to commend the authors for conducting this study, which explores taboo topics such as kidney failure, disease, and depression as a mental disorder. In my daily work, I advocate increasing education and awareness in the kidney community through public speaking, writing, and mass and social media.
Having had CKD since I was 3 years old, when growing up, I was told not to share about my personal CKD, kidney donation, and transplantation, or any emotional disturbances I was experiencing. I received my second kidney transplant on the cusp of being a teenager, which was already a very emotional and challenging time, and was exacerbated by dealing with my failing first transplanted kidney and the many immunosuppressant medications I was taking.
The findings of the article do not surprise me: when people are depressed, they are not as motivated to care for themselves. When I was depressed, I felt paralyzed. However, I was very fortunate that I was an advocate who was motivated to navigate my care at the time. I sought resources within my kidney transplant team, such as social workers.
In the United States, we are very fortunate to have social workers to assist with social, emotional, and mental challenges. Mental health services need to be available when a person is in decline, not just in the final stages of kidney disease.
For future studies, I would highly hope and suggest the study is expanded to the Asian population in the United States, and to teenagers and young adult transplant recipients who have been shown to experience depression. It would also be helpful for the investigators to explore and include anxiety with depression, because these are very common challenges that those with kidney failure, and even a chronic illness, experience. Another thought is to examine males versus females and which sex may experience more depression. Lastly, my recommendation is that these studies possibly include solutions and resources for those suffering from depression and CKD.
Thank you to the researchers and participants of this very vital study. I look forward to further studies to come.
The author has nothing to disclose.
The content of this article reflects the personal experience and views of the author(s) and should not be considered medical advice or recommendation. The content does not reflect the views or opinions of the American Society of Nephrology (ASN) or CJASN. Responsibility for the information and views expressed herein lies entirely with the author(s).
The author would like to acknowledge Lori Hartwell and her staff/Renal Support Network and the American Society of Nephrology for their continued efforts in kidney care and community. For more information on the author, please visit http://www.thewuway.com.
1. Zhang Z, He P, Liu M, Zhou C, Liu C, Li H, Zhang Y, Li Q, Ye Z, Wu Q, Wang G, Liang M, Qin X: Association of depressive symptoms with rapid kidney function decline
in adults with normal kidney function. Clin J Am Soc Nephrol 16: 889–897, 2021