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BACKGROUND: Psychosocial factors including depression, anxiety and lower social support are common in patients with chronic kidney disease (CKD). However the influence of these potentially modifiable risk factors on morbidity and mortality in this renal population is unknown. The Tasmanian Chronic Kidney Disease study is a prospective cohort study which aims to examine the influence of both biomedical and psychosocial factors on disease progression, decision making and length and quality of life in adults with severe CKD, prior to kidney replacement therapy. This paper describes the recruitment, baseline characteristics and initial follow-up of pilot participants. METHODS: Adults aged > 18 years with stage 4 CKD (eGFR 15--29 mls/min/1.73 m2) and not receiving dialysis were recruited via treating physicians. Measures included depression (9-item Patient Health Questionnaire), anxiety (Beck Anxiety Inventory) and social support (Multidimensional Scale of Perceived Social Support). Primary outcomes were kidney disease progression, use of kidney replacement therapy and health-related quality of life (Kidney Disease and Quality of Life Short Form and the EQ-5D). RESULTS: Of those invited (n = 105), 49 provided consent and completed baseline assessment. There were no significant differences between responders and non-responders in age, gender and socio-economic status (all p > 0.05). Participants were predominantly male (63.3%) with a mean age of 72.6 +/- 10.2 years. Mean serum creatinine was 241 +/- 62 mumol/L with mean GFR 22 +/- 5 mls/min/1.73 m2. Prevalence of major depression and moderate to severe anxiety was 10% and 9% respectively. Less severe depression and fewer anxiety symptoms were associated with higher health-related quality of life. Follow-up at 10-months showed CKD progression in 34% of participants (use of KRT in 16%, stage 5 CKD without KRT in 18%), one death, with the remainder stable at CKD stage 3 or 4. CONCLUSIONS: Results indicate that a larger prospective study is feasible and has the capacity to examine the influence of biomedical and psychosocial factors on kidney disease progression, use of dialysis and transplantation, and salient personal and economic outcomes. Findings have the potential to provide an evidence base for revising healthcare provision in order to optimize the care of patients with CKD.

Item Type:	Refereed Article
Keywords:	anxiety, chronic kidney disease, cohort, depression, health-related quality of life, social support
Research Division:	Health Sciences
Research Group:	Epidemiology
Research Field:	Epidemiology not elsewhere classified
Objective Division:	Health
Objective Group:	Public health (excl. specific population health)
Objective Field:	Mental health
UTAS Author:	McKercher, CM (Dr Charlotte McKercher)
UTAS Author:	Venn, AJ (Professor Alison Venn)
UTAS Author:	Blizzard, L (Professor Leigh Blizzard)
UTAS Author:	Nelson, MR (Professor Mark Nelson)
UTAS Author:	Palmer, AJ (Professor Andrew Palmer)
UTAS Author:	Ashby, MA (Professor Michael Ashby)
UTAS Author:	Scott, JL (Professor Jenn Scott)
UTAS Author:	Jose, MD (Professor Matthew Jose)
ID Code:	84189
Year Published:	2013
Web of Science® Times Cited:	26
Deposited By:	Menzies Institute for Medical Research
Deposited On:	2013-04-29
Last Modified:	2017-11-07
Downloads:	398 View Download Statistics