Depressive and anxiety symptoms tied to progression to kidney failure in patients with diabetic nephropathy: Study

This study aimed to analyze the associations between depressive and anxiety symptoms and the risk of incident kidney failure in patients with biopsy-proven diabetic nephropathy (DN).

This retrospective study enrolled 241 type 2 diabetic patients with biopsy-proven diabetic nephropathy. Huaxi Emotional-Distress Index (HEI) was used to evaluate the depression and anxiety status of patients on admission. According to the HEI score, diabetic nephropathy patients were divided into HEI score ≤ 8 group (without depression and anxiety) and HEI score > 8 group (with depression and anxiety).

The study endpoint was defined as progression to kidney failure. The Cox proportional hazard analysis was performed to investigate the risk factors for progression to kidney failure in diabetic nephropathy patients. Results: Twenty-three patients had HEI scores> 8, accounting for about 9.5% of all patients. Compared with the HEI score ≤ 8 group, those with HEI score > 8 had more severe proteinuria, higher systolic blood pressure, and lower baseline eGFR and serum albumin levels. During a median follow-up of 28 months, the outcome event occurred in 89 (36.9%) of all the patients.

After multivariable adjustment, HEI score > 8 was associated with an increased risk of progression to kidney failure. Depressive and anxiety symptoms might be associated with an increased risk of progression to kidney failure in patients with diabetic nephropathy, which implies psychosocial issues should be early screened, assessed and intervened to delay the progression of diabetic nephropathy.

Qin, C., Wu, Y., Zou, Y. et al. Associations between depressive and anxiety symptoms and incident kidney failure in patients with diabetic nephropathy. BMC Nephrol 26, 54 (2025). https://doi.org/10.1186/s12882-025-03983-x