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. 2022 Nov;41(6):753-763.
doi: 10.23876/j.krcp.21.311. Epub 2022 Sep 8.

Associations among Alzheimer disease, depressive disorder, and risk of end-stage kidney disease in elderly people

Shin Chan Kang  1 , Hee Byung Koh  1 , Hyung Woo Kim  1 , Young Su Joo  2 , Seung Hyeok Han  1 , Tae-Hyun Yoo  1 , Shin-Wook Kang  1 , Jung Tak Park  1
Affiliations

Associations among Alzheimer disease, depressive disorder, and risk of end-stage kidney disease in elderly people

Shin Chan Kang et al. Kidney Res Clin Pract. 2022 Nov.

Abstract

Background: Alzheimer disease (AD) and depressive disorder (DD) are prevalent among elderly end-stage kidney disease (ESKD) patients. However, whether preexisting mental health disorders increase the risk of ESKD is not well understood. The risk of incident ESKD in patients with or without underlying AD or DD was evaluated in a nationwide cohort of elderly people in Republic of Korea.

Methods: This study used data from the National Health Insurance Service-Senior cohort in Republic of Korea. Among the 558,147 total subjects, 49,634 and 54,231 were diagnosed with AD (AD group) or DD (DD group), respectively, during the follow-up period. Propensity score matching was conducted to create non-AD and non-DD groups of subjects. AD and DD diagnoses were analyzed as time-varying exposures, and the study outcome was development of ESKD.

Results: The incidence rates of ESKD were 0.36 and 1.17 per 1,000 person-years in the non-AD and AD groups, respectively. After adjustment for clinical variables and competing risks of death, the risk of incident ESKD was higher in the AD group than in the nonAD group (hazard ratio [HR], 1.67; 95% confidence interval [CI], 1.34-2.08). The incidence rates of ESKD in the non-DD and DD groups were 0.36 and 0.91 per 1,000 person-years, respectively. The risk of ESKD development was also higher in the DD group than the non-DD group (HR, 1.44; 95% CI, 1.19-1.76).

Conclusion: The risk of ESKD development was higher in subjects diagnosed with AD or DD, suggesting that central nervous system diseases can adversely affect kidney function in elderly people.

Keywords: Alzheimer disease; Depressive disorder; Elderly; End-stage kidney disease.

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Conflict of interest statement

Conflicts of interest

Tae-Hyun Yoo is the Editor-in-Chief of Kidney Research and Clinical Practice and was not involved in the review process of this article. All authors have no other conflicts of interest to declare.

Figures

Figure 1.
Figure 1.. Flow diagram of the study.
NHIS, National Health Insurance Service; AD, Alzheimer disease; DD, depressive disorder; ESKD, end-stage kidney disease.
Figure 2.
Figure 2.. Schematic depiction of the study design.
AD, Alzheimer disease; DD, depressive disorder; ESKD, end-stage kidney disease; ICD-10, International Classification of Diseases, 10th revision; KOSIS, Korean Statistical Information Service. NHIS-Senior, National Health Insurance Service-Senior
Figure 3.
Figure 3.. Cumulative incidence curves of incident end-stage kidney disease in propensity score-matched subjects diagnosed with AD (A) or DD (B).
Adjusted for clinical variables used to estimate propensity scores (listed in Table 1) and competing risk of all-cause death. AD, Alzheimer disease; DD, depressive disorder; CI, confidence interval; sHR, subdistribution hazard ratio.
See this image and copyright information in PMC

References

    1. National Institutes of Health (NIH)/World Health Organization . Bethesda (MD): NIH; c2011. Global health and aging [Internet] [cited 2021 Dec 29]. Available from: https://www.nia.nih.gov/sites/default/files/2017-06/global_health_aging.pdf.
    1. World Health Organization (WHO) Geneva (Switzerland): WHO; c2017. Mental health of older adults [Internet] [cited 2021 Dec 29]. Available from: https://www.who.int/news-room/fact-sheets/detail/mental-health-of-older-....
    1. World Health Organization (WHO) Geneva (Switzerland): WHO; c2017. Global action plan on the public health response to dementia 2017–2025 [Internet] cited 2021 Dec 29]. Available from: https://www.who.int/publications/i/item/global-action-plan-on-the-public....
    1. Luppa M, Sikorski C, Luck T, et al. Age- and gender-specific prevalence of depression in latest-life: systematic review and meta-analysis. J Affect Disord. 2012;136:212–221. - PubMed
    1. Bugnicourt JM, Godefroy O, Chillon JM, Choukroun G, Massy ZA. Cognitive disorders and dementia in CKD: the neglected kidney-brain axis. J Am Soc Nephrol. 2013;24:353–363. - PubMed

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