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. 2023 Aug 1;4(8):1072-1079.
doi: 10.34067/KID.0000000000000179. Epub 2023 Jun 19.

Coping Behaviors and Incident Kidney Disease

Tessa K Novick  1 , James Custer  2 , Alan B Zonderman  3 , Michele K Evans  3 , Melissa Hladek  4 , Marie Kuczmarski  3 , Paul J Rathouz  2 , Deidra C Crews  5
Affiliations

Coping Behaviors and Incident Kidney Disease

Tessa K Novick et al. Kidney360. .

Abstract

Key Points:

  1. Adaptive coping behaviors are associated with lower odds of incident CKD.

  2. Coping behaviors could represent a target to prevent CKD.

Background: How someone copes may alter the trajectory of their kidney function. We aimed to evaluate whether coping behaviors were associated with incident CKD or rapid kidney function decline.

Methods: We used data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study (Baltimore, MD) for this longitudinal analysis. Adaptive and maladaptive coping behavioral constructs were measured using the Brief COPE Inventory at visit 1. We used multiple logistic regression to assess the odds of incident CKD and rapid kidney function decline per point increase in coping scales and adjusted for baseline demographics and clinical variables.

Results: Of 1935 participants, mean age was 48 years, 44% were male, 56% were Black persons, and baseline mean (SD) eGFR was 91 (16) ml/min per 1.73 m2. After a median of 8.2 years, 113 participants developed incident CKD and 341 had rapid kidney function decline. Compared with those who reported they usually did not use adaptive coping behaviors at all (such as emotional support), those with the highest use of adaptive coping had lower odds of incident CKD. Every 1-unit increase in adaptive coping corresponded with a 2% lower adjusted odds of incident CKD (odds ratio, 0.98; 95% confidence interval, 0.95 to 0.99). There was no association between maladaptive coping behaviors and incident CKD. Coping behaviors were not associated with rapid kidney function decline.

Conclusions: Adaptive coping behaviors were associated with lower odds of incident CKD and could represent a target to facilitate CKD prevention. The role of medical care in this association is an area worthy of further investigation.

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Conflict of interest statement

D.C. Crews reports the following: Consultancy: Yale New Haven Health Services Corporation Center for Outcomes Research and Evaluation (CORE); Research Funding: Baxter International; Somatus, Inc.; Honoraria: Maze Therapeutics; Advisory or Leadership Role: Editorial Board—Journal of Renal Nutrition, Clinical Journal of the American Society of Nephrology, Journal of the American Society of Nephrology; Associate Editor, Kidney360; Co-Chair, Bayer HealthCare Pharmaceuticals Inc. Patient and Physician Advisory Board Steering Committee for Disparities in CKD Project; Advisory Group, Health Equity Collaborative, Partner Research for Equitable System Transformation after COVID-19 (PRESTA), Optum Labs; and Other Interests or Relationships: Board of Directors, National Kidney Foundation of Maryland/Delaware; Nephrology Board, American Board of Internal Medicine; Council of Subspecialist Societies, American College of Physicians; Executive Councilor, American Society of Nephrology. T.K. Novick reports the following: Consultancy: Cricket Health. P.J. Rathouz reports the following: Consultancy: Consultant for Sunovion Pharmaceuticals, unrelated to this work presented here. All remaining authors have nothing to disclose.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Study flow diagram. We defined incident CKD as the first occurrence of eGFR <60 ml/min per 1.73 m2 and ≥25% decline in eGFR at study visits 3 or 4 in relation to visit 1 and rapid decline as eGFR loss of >3 ml/min per 1.73 m2 per year between study visits 3 and 4. The rapid kidney function decline analytic sample was smaller because there were fewer participants who had eGFR data from both visits 3 and 4. HANDLS, Healthy Aging in Neighborhoods of Diversity across the Life Span.
Figure 2.
Figure 2.
Subscales of the Brief COPE Inventory.
Figure 3.
Figure 3.
Relationship of coping behaviors with incident CKD (eGFR <60 ml/min per 1.73 m2 and ≥25% decline at study visits 3 or 4 in relation to visit 1) and rapid kidney function decline (eGFR loss of >3 ml/min per 1.73 m2 per year). P values correspond with associations between one-point increase in coping scales and outcomes.
See this image and copyright information in PMC

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