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A systematic review and meta-analysis of the evidence on inflammation in depressive illness and symptoms in chronic and end-stage kidney disease

Published online by Cambridge University Press:  18 October 2022

Simone Jayakumar Open the ORCID record for Simone Jayakumar [Opens in a new window] ,
Stacey Jennings ,
Kristoffer Halvorsrud ,
Christophe Clesse ,
Muhammad Magdi Yaqoob ,
Livia A. Carvalho  and
Kamaldeep Bhui
Simone Jayakumar*
Affiliation:
Center for Psychiatry and Mental Health, Wolfson Institute of Population Health, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK Department of Clinical Pharmacology, William Harvey Research Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
Stacey Jennings
Affiliation:
Center for Psychiatry and Mental Health, Wolfson Institute of Population Health, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
Kristoffer Halvorsrud
Affiliation:
Department of Applied Health Research, University College London, London, UK
Christophe Clesse
Affiliation:
Center for Psychiatry and Mental Health, Wolfson Institute of Population Health, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK Department of Clinical Pharmacology, William Harvey Research Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
Muhammad Magdi Yaqoob
Affiliation:
Translational Medicine and Therapeutics, William Harvey Research Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
Livia A. Carvalho
Affiliation:
Department of Clinical Pharmacology, William Harvey Research Institute, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
Kamaldeep Bhui
Affiliation:
Center for Psychiatry and Mental Health, Wolfson Institute of Population Health, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, London, UK Department of Psychiatry and Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK East London NHS Foundation Trust and Oxford Health NHS Foundation Trust, London, UK
*
Author for correspondence: Simone Jayakumar, E-mail: simone.jayakumar@qmul.ac.uk
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Abstract

Background

Depression affects approximately 27% of adults with chronic kidney disease (CKD) and end-stage kidney failure (ESKF). Depression in this population is associated with impaired quality of life and increased mortality. The extent of inflammation and the impact on depression in CKD/ESKF is yet to be established. Through a systematic literature review and meta-analysis, we aim to understand the relationship between depression and inflammation in CKD/ESKF patients.

Methods

We searched nine electronic databases for published studies until January 2022. Titles and abstracts were screened against inclusion and exclusion criteria. Data extraction and study quality assessment was carried out independently by two reviewers. A meta-analysis was carried out where appropriate; otherwise a narrative review of studies was completed.

Results

Sixty studies met our inclusion criteria and entered the review (9481 patients included in meta-analysis). Meta-analysis of cross-sectional associations revealed significantly higher levels of pro-inflammatory biomarkers; C-reactive protein; Interleukin 6 (IL-6) and tumour necrosis factor-alpha in patients with depressive symptoms (DS) compared to patients without DS. Significantly lower levels of anti-inflammatory cytokine IL-10 were found in patients with DS compared to patients without DS. Considerable heterogeneity was detected in the analysis for most inflammatory markers.

Conclusion

We found evidence for an association of higher levels of pro-inflammatory and lower anti-inflammatory cytokines and DS in patients with CKD/ESKF. Clinical trials are needed to investigate whether anti-inflammatory therapies will be effective in the prevention and treatment of DS in these patients with multiple comorbidities.

Keywords

Chronic kidney disease (CKD)cytokinedepressiondepressive symptomsend-stage kidney failure (ESKF)inflammationinflammatory biomarkersmajor depressive disordermeta-analysissystematic review
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 12 , September 2023 , pp. 5839 - 5851
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Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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Footnotes

*

L.A. Carvalho and Kamaldeep Bhui share senior co-authorship.

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