Kidney Disease and Depression: The Need for Support

When it comes to chronic medical conditions, diabetes, high blood pressure and heart disease are often top of mind. But there is another chronic disease that needs attention—especially as it relates to depression. That disease is Chronic Kidney Disease (CKD).


The Stats


According to the CDC:

  • 37 million adults in the U.S. have CKD—over 14%

  • As many as 9 in 10 adults with CKD don’t know it

  • About 2 in 5 adults with severe CKD don’t realize it

This disease has caught the attention of some, specifically Monogram Health—a tech-empowered kidney disease management company. This start-up received $160 million in funding from Humana in June 2021 and is building a national network of nurses, nephrologists, dieticians, pharmacists and social workers.


But another health care professional plays an essential role in managing CKD—the mental health practitioner.


There’s a high prevalence of depression and anxiety among patients with CKD. Depression has long been associated with end-stage kidney disease. But, as high as 34.5% of patients on dialysis are likely to develop depression and close to 24% of patients with CKD suffer from depression.


Another study published in the American Journal of Kidney Diseases found that 20% of patients with early-stage chronic kidney disease also suffered from depression.


A patient with CKD may or may not be on dialysis, and the damage to the kidney may be reversible. CKD is a progressive disease that can move through five stages diagnosed by specific tests. Following stage five is End-Stage Renal Disease (ESRD). A patient diagnosed with ESRD requires ongoing dialysis or a kidney transplant. It’s not reversible.


As reported by the National Kidney Foundation, people with CKD (even in its earliest stages) who are unemployed, have diabetes or other chronic medical conditions, or have other mental health issues are more prone to experience depression.


Depression is the most widely acknowledged psychosocial factor seen in patients with CKD and is associated with poor outcomes.


The Effect on Caregivers


A study exploring the prevalence of depression among patients with chronic kidney disease and their caregivers found caregivers of patients undergoing dialysis experience depression, anxiety, fatigue, social isolation, relationship strains and more. Despite the burdens experienced by caregivers, they are not often given the support they need.


Studies done among caregivers of patients with chronic illnesses showed that depression, anxiety, excessive medication use and impaired quality of life were associated with caregiving of these patients. Plus, caregivers experiencing these issues were found to have higher mortality rates. Yet, the report also revealed that only 56% of the caregivers know they are at risk for depression.


CKD patients and their caregivers need to be educated on their risk of depression and the factors that can influence the development of depression. Psychological and social support for both the patient and caregiver—especially if a spouse or other close relative— should become an integral part of the treatment plan before symptoms of depression or other mental health issues develop.