Vitamin D deficiency is significantly associated with depression in patients with chronic kidney disease

PLoS One. 2017 Feb 13;12(2):e0171009. doi: 10.1371/journal.pone.0171009. eCollection 2017.

Abstract

Background: Depression is reported to be the most common psychological problem in patients with chronic kidney disease (CKD). Several studies have reported that lower levels of serum vitamin D are significantly associated with depression. Both vitamin D deficiency and depression are prevalent in patients with CKD, yet the relationship between these two factors remains poorly understood. This study aimed to investigate the association between vitamin D levels and depression among CKD patients.

Methods: Totally, 21,257 individuals who participated in the Korean National Health and Nutrition Examination Survey (KNHANES V, VI) from 2010-2014 were screened for the study; 533 CKD patients were included. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D3 [25(OH)D3] ≤10 ng/mL. Patients were divided into vitamin D deficient or sufficient groups. Depression was screened for using the Korean version of the WHO Composite International Diagnostic Interview-Short Form. The association between vitamin D deficiency and depression was evaluated by multivariate logistic regression analysis.

Results: The mean participant age was 70.1±9.4 years; 262 patients (49.2%) were male. The median 25(OH)D3 level was 19.1±6.9 ng/mL. The prevalence of depression was higher in CKD patients than in the general population (14.3 vs. 11.1%, P = 0.03). Additionally, the prevalence of depression was significantly higher in CKD patients with (vs. without) vitamin D deficiency (32.5% vs. 50.0%, P<0.001). Multivariate logistic regression analysis showed that vitamin D deficiency was a significant independent predictor of depression after adjusting for confounding factors (adjusted odds ratio, 6.15; 95% confidence interval, 2.02-8.75; P = 0.001).

Conclusion: Depression was highly prevalent in CKD patients, in whom vitamin D deficiency was a significant independent predictor of depression. Therefore, management of vitamin D deficiency might help prevent depression in CKD patients.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asian People
  • Comorbidity
  • Depressive Disorder / blood*
  • Depressive Disorder / epidemiology
  • Depressive Disorder / ethnology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nutrition Surveys / methods
  • Nutrition Surveys / statistics & numerical data
  • Prevalence
  • Renal Insufficiency, Chronic / blood*
  • Renal Insufficiency, Chronic / epidemiology
  • Renal Insufficiency, Chronic / ethnology
  • Republic of Korea / epidemiology
  • Risk Factors
  • Vitamin D / blood*
  • Vitamin D Deficiency / blood*
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / ethnology

Substances

  • Vitamin D

Grants and funding

The authors received no specific funding for this work.