Clinical Depression is highly prevalent in patients living with Diabetic Kidney
Disease (DKD) and Diabetes Mellitus 2 (DM2) and is related to high morbidity and mortality,
in addition, Health-Related Quality of Life (HRQoL) is also potentially impacted in these
patients. Vitamin D (VD) deficiency has been associated with depression and worse HRQoL
in patients with DRD. This study aims to investigate the association between vitamin D
levels, HRQOL and depression in patients with DRD who are not receiving dialysis
treatment. To this end, this was a cross-sectional study, which included 51 patients with DM2
and DRD, not on dialysis and with severely elevated albuminuria, treated at the João de
Barros Barreto University Hospital. To measure depressive symptoms (SD), the Beck
Depression Inventory (BDI) was used and HRQoL was analyzed using the EQ-5D-5L
instrument. Additionally, the Glomerular Filtration Rate estimate was calculated by CKD-EPI
Refit. Result: The prevalence of depression was 46.9% and was strongly associated with
quality of life levels assessed by the EQ-5D. Impacting both domains and utility indices
(Domain “Pain and discomfort” 0.7±0.8 vs 1.1±0.8, p<0.05; Utility index “United States”
0.89 [0.78-1] vs 0.71[0.60-0.84], p<0.05). Worse quality of life was even associated with the
severity of depression. With regard to DV, it directly impacted HRQoL, but no direct
association was found between DV and depression. Models with simple logistic regression
showed that patients with peripheral neuropathy (PN) had a six times greater risk of
experiencing depression (OR 6.56, R²=0.12, p<0.05). Additionally, the duration of DM2 was
also important, with each year of illness increasing the risk of depression by 12% (OR 1.135,
R²=0.18, p<0.05). The data suggested that depression has a high prevalence in patients with
T2DM and DRD and is strongly associated with low levels of HRQoL. HV impacted quality
of life, but was not directly associated with the prevalence and severity of depression.
|
