• J Gen Intern Med · Oct 2021

    Effect of Psychosocial Distress on the Rate of Kidney Function Decline.

    • Jae Young Kim, Young Su Joo, Jong Hyun Jhee, Seung Hyeok Han, Tae-Hyun Yoo, Shin-Wook Kang, and Jung Tak Park.
    • Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea.
    • J Gen Intern Med. 2021 Oct 1; 36 (10): 2966-2974.

    BackgroundsChronic kidney disease is a growing global health problem. Psychosocial stress has been found to induce changes in biological processes and behavioral patterns that increase risks of cardiovascular and metabolic diseases. However, the association between psychosocial stress and kidney function is not well understood.ObjectiveTo evaluate the association between psychosocial stress and kidney function decline.DesignIn this prospective cohort study, psychosocial distress was assessed using the psychosocial well-being index short-form (PWI-SF).ParticipantsData of a total of 7246 participants were retrieved from a community-based cohort (Korean Genome and Epidemiology Study).Main MeasuresThe rate of estimated glomerular filtration rate (eGFR) decline was calculated for each individual. Rapid eGFR decline was defined as a decrease of ≥ 3 mL/min/1.73 m2 per year. The presence of kidney disease was defined as eGFR < 60 mL/min/1.73 m2 at baseline or proteinuria of higher than trace levels from two consecutive urine test results.Key ResultsA total of 7246 participants were analyzed. The mean eGFR was 92.1 ± 14.0 mL/min/1.73 m2. Rapid eGFR decline was observed in 941 (13.0%) participants during a median follow-up of 11.7 years. When the participants were categorized into tertiles according to PWI-SF score, rapid eGFR decline was more prevalent in the group with the highest PWI-SF score (15.8%) than in the group with the lowest score (12.2%). Multivariate logistic regression analysis revealed that the risk of rapid eGFR decline was significantly increased in the tertile group with the highest PWI-SF score compared to the lowest group (odds ratio, 1.35; 95% confidence interval, 1.15-1.59). This association was maintained even after adjusting for confounding variables and excluding participants with kidney disease.ConclusionsHigher levels of psychosocial distress were closely associated with an increased risk of rapid kidney function decline.© 2021. Society of General Internal Medicine.

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