10 Nov Depression Raises Risks of Kidney and Heart Disease in Diabetic Patients
Dr. Molnar
MedicalResearch.com Interview with:
Miklos Z Molnar, MD, PhD, FEBTM, FERA, FASN
Associate Professor of Medicine
Division of Nephrology, Department of Medicine
University of Tennessee Health Science Center
Memphis, TN, 38163
Medical Research: What is the background for this study? What are the main findings?
Dr. Molnar: We examine the association between presence of depression and all-cause mortality; incident Coronary Heart Disease (CHD) (new onset AMI, CABG or PCI), incident ischemic stroke, slopes of eGFR (OLS, <-5 vs ≥-5 ml/min/1.73m2/yr) in 933,211 diabetic (based on ICD9, medication and HbA1c ≥ 6.5%) US Veterans with eGFR ≥ 60 ml/min/1.73m2 at baseline. We adjusted for independent covariates, collected from VA databases, such as age, gender, race, BMI, marital status, income, service connection, comorbid conditions (ICD9), baseline eGFR, serum albumin.
Mean age was 64±11 years, 97% were male and 18% African-American. Depression was present in 340,806 (37%) patients at enrollment. During a median follow-up of 7.3 years, 180,343 patients (19%) developed Chronic Kidney Disease (CKD).AS (adjusted hazard ratio [aHR] and 95% confidence interval [CI]: 1.20 (1.19-1.21)). Similarly, depression was associated with 35% higher risk of incident stroke (aHR and 95% CI: 1.35 (1.32-1.39), 24% higher risk of incident CHD (aHR and 95% CI: 1.24 (1.22-1.27) and 25% higher risk of all cause mortality (aHR and 95% CI: 1.25 (1.24-1.26) during the follow-up.
Medical Research: What should clinicians and patients take away from your report?
Dr. Molnar: Comorbid depression is associated with increased risk of developing Chronic Kidney Disease in diabetic patients. Similarly, the presence of depression is associated with worse cardiovascular outcomes.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Molnar: Appropriate intervention studies are needed to determine if treating depression in patients with diabetes would prevent Chronic Kidney Disease and cardiovascular disease.
Citation:
Presented at the 2015 ASN November 2015
Increased Risk of Incident Chronic Kidney Disease, Cardiovascular Disease and Mortality in Diabetic Patients with Comorbid Depression Miklos Zsolt Molnar,2 Marta Novak,1 Istvan Mucsi,1 Jun Ling Lu,2 Kamyar Kalantar-Zadeh,3 Csaba P. Kovesdy.2,4 1Univ Health Network, Univ of Toronto, Toronto, ON, Canada; 2Univ of Tenessee Health Sciences Center, Memphis, TN; 3Univ of California, Irvine, CA; 4Veterans Affairs Medical Center, Memphis, TN.
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Depression Raises Risks of Kidney and Heart Disease in Diabetic Patients (2015). Miklos Z Molnar, MD, PhD
Last Updated on November 10, 2015 by Marie Benz MD FAAD