Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 1;6(4):561-572.
doi: 10.34067/KID.0000000683. Epub 2024 Dec 23.

Depressive Symptoms in Adults with Autosomal Dominant Polycystic Kidney Disease

Caroline J Yi  1 , Terry T Watnick, Stephen L Seliger
Affiliations

Depressive Symptoms in Adults with Autosomal Dominant Polycystic Kidney Disease

Caroline J Yi et al. Kidney360. .

Abstract

Key Points:

  1. Our results show a relatively low prevalence of elevated depressive symptoms in a large sample of predialysis adult patients with autosomal dominant polycystic kidney disease.

  2. Frequent pain was found to have a significant association with depressive symptoms, underscoring the importance of adequate pain control.

  3. The severity of autosomal dominant polycystic kidney disease was not associated with depressive symptoms after accounting for potential demographic and clinical factors.

Background: Patients with autosomal dominant polycystic kidney disease (ADPKD) face mental health challenges linked to disease progression and its heritable nature. Prior studies reported mixed associations between depressive symptoms and ADPKD severity and progression. In this study, we assessed depressive symptoms and disease severity over 3 years in patients with ADPKD without ESKD.

Methods: Two hundred eighty-three adults with ADPKD were enrolled from April 2013 to June 2023 in a single-center prospective observational study. ADPKD severity was assessed with estimated GFR and height-adjusted total kidney volume (htTKV). Depressive symptoms were assessed with the Beck Depression Inventory II. Depressive symptom burden was compared with previously reported cohorts of patients with other chronic, progressive diseases. The relationship of ADPKD severity and ADPKD-related pain with depressive symptoms was estimated using multiple linear regression, adjusting for potential confounders.

Results: Among 283 adult patients with ADPKD (mean age 45 years; 81% White; 61% female), 15.5% reported moderate depressive symptoms (Beck Depression Inventory II ≥11). Depressive symptom prevalence (all ages) was lower than in primary care samples. For the older patients in our cohort, depressive symptom prevalence was similar to those in healthy older adults. ADPKD severity (eGFR, 73±33 ml/min per 1.73 m2; htTKV, 1104±80 cc/m) was unrelated to depressive symptoms, although frequent pain (abdominal, back, and/or flank pain experienced at least daily) was strongly associated with higher depressive symptom levels. Baseline depressive symptoms did not predict kidney function (eGFR, htTKV) at 36 months, adjusting for baseline measures and confounders.

Conclusions: Our results reveal a relatively low prevalence of clinically significant depressive symptoms in a large sample of adult patients with ADPKD who were not undergoing KRT. However, frequent pain was associated with a greater degree of depressive symptoms, underscoring the importance of adequate pain control. Although these findings highlight the resilience of patients with ADPKD, routine mental health screening is recommended, and validated pain assessment tools may provide useful resources to quantify and manage pain in ADPKD.

Keywords: ADPKD; depression; epidemiology and outcomes.

PubMed Disclaimer

Conflict of interest statement

Disclosure forms, as provided by each author, are available with the online version of the article at http://links.lww.com/KN9/A828.

Figures

None
Graphical abstract
Figure 1
Figure 1
Healthy older adults (Stewart et al.), patients with CKD (Weiner et al.), Black patients with CKD (Fischer et al.), patients with ALS (Taylor et al.), primary care patients (Arnau et al.), premanifest carriers of HD (Aziz et al.), patients with T1DM (Gendelman et al.), patients with chronic hepatitis C (Dbouk et al.), and patients with chronic pain (Harris et al.). The y axis (“depressive symptoms”) depicts the test statistic for the Wilcoxon rank sum test, which represents a difference in location. This describes the median of the differences between a sample from group X and a sample from group Y. For example, the test statistic for the ALS group can be interpreted as follows: the median difference in total BDI-II scores between a patient with ALS and a patient from our ADPKD cohort (age ≥55) was 11. The CI indicates that if we repeated the study 100 times, 95% of the differences in location would fall between 8.3 and 12.9. ADPKD, autosomal dominant polycystic kidney disease; ALS, amyotrophic lateral sclerosis; BDI-II, Beck Depression Inventory II; CI, confidence interval; HD, Huntington disease; Hep, hepatitis; T1DM, type 1 diabetes mellitus.
Figure 2
Figure 2
Individual change in BDI-II.
Figure 3
Figure 3
Change in kidney function and depressive symptoms over 36 months. htTKV, height-adjusted total kidney volume.
See this image and copyright information in PMC

References

    1. Tong A Rangan GK Ruospo M, et al. A painful inheritance - patient perspectives on living with polycystic kidney disease: thematic synthesis of qualitative research. Nephrol Dial Transplant. 2015;30(5):790–800. doi: 10.1093/ndt/gfv010 - DOI - PubMed
    1. Rizk D Jurkovitz C Veledar E, et al. Quality of life in autosomal dominant polycystic kidney disease patients not yet on dialysis. Clin J Am Soc Nephrol. 2009;4(3):560–566. doi: 10.2215/CJN.02410508 - DOI - PMC - PubMed
    1. Simms RJ, Thong KM, Dworschak GC, Ong ACM. Increased psychosocial risk, depression and reduced quality of life living with autosomal dominant polycystic kidney disease. Nephrol Dial Transplant. 2016;31(7):1130–1140. doi: 10.1093/ndt/gfv299 - DOI - PubMed
    1. Miskulin DC Abebe KZ Chapman AB, et al. Health-related quality of life in patients with autosomal dominant polycystic kidney disease and CKD stages 1-4: a cross-sectional study. Am J Kidney Dis. 2014;63(2):214–226. doi: 10.1053/j.ajkd.2013.08.017 - DOI - PMC - PubMed
    1. Hernandez R Xie D Wang X, et al. Depressive symptoms, antidepressants, and clinical outcomes in chronic kidney disease: findings from the CRIC study. Kidney Med. 2024;6(4):100790. doi: 10.1016/j.xkme.2024.100790 - DOI - PMC - PubMed