Diabetics also suffering from depression may need to watch out for a triple whammy, with renal failure now linked to sufferers of the two conditions. According to a new study, findings reveal that diabetics with major depression are at a greater risk of kidney failure than diabetics with more stable mental health.
Though some overlap has previously been noted in the symptoms of major depression and kidney disease, no study has looked at the relationship between the two among diabetics. However, prior studies have looked at the connection between diabetes and depression, without accounting for kidney health. Those studies have resulted in conflicted findings, with a 2010 study finding that Type 2 diabetics are at an increased risk of microvascular illness.
The study looked at approximately 3,886 adult diabetics, around 12 percent of whom suffered from serious depression. A further nine percent exhibited symptoms of minor depression. Researchers observed the patients for an average of 8.8 years, finding that the group suffering from major depression was 85 percent more likely to develop renal failure.
"Although patients with diabetes mellitus are at high risk for end-stage renal disease (ESRD), to our knowledge this is the first study to show an association between major depressive symptoms and long-term ESRD risk in this population," said lead researcher Dr. Margaret Yu, a fellow of nephrology at the University of Washington in Seattle. She continued: "We have known that patients on dialysis have a higher prevalence of depression, but we have only recently started to look at the impact of depression on people with earlier stages of kidney disease."
The study looked at tests revealing kidney function, questionnaires designed to identify depressive symptoms, and the methods of managing diabetes and how well the participants adhered to them - for example, diet, exercise, and observing insulin and blood sugar levels. They also factored in age, years living with diabetes, marital status, ethnicity, education, body mass index, blood pressure, and whether or not the participant smoked.
The findings revealed key points about the patients suffering from depression. Typically, they were more likely to skew female, young, non-Hispanic black, with higher BMIs and more likely to smoke. Overall, they tended to have lower salaries and education levels than others in the cohort that did not suffer from depression.
Yu was quick to urge that diabetes sufferers be subjected to greater education around depressive symptoms to combat both depression and renal disease. "We need to raise awareness among health care providers about the magnitude of this problem," she said. "Many suspect this but have not recognized it completely. Our patients are at high risk for depression and can have poor outcomes as a result."
The study was published in the Clinical Journal of the American Society of Nephrology.
