Effect of Psychosocial Distress on the Rate of Kidney Function Decline

Jae Young Kim, Young Su Joo, Jong Hyun Jhee, Seung Hyeok Han, Tae Hyun Yoo, Shin Wook Kang, Jung Tak Park

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Backgrounds: Chronic kidney disease is a growing global health problem. Psychosocial stress has been found to induce changes in biological processes and behavioral patterns that increase risks of cardiovascular and metabolic diseases. However, the association between psychosocial stress and kidney function is not well understood. Objective: To evaluate the association between psychosocial stress and kidney function decline. Design: In this prospective cohort study, psychosocial distress was assessed using the psychosocial well-being index short-form (PWI-SF). Participants: Data of a total of 7246 participants were retrieved from a community-based cohort (Korean Genome and Epidemiology Study). Main Measures: The rate of estimated glomerular filtration rate (eGFR) decline was calculated for each individual. Rapid eGFR decline was defined as a decrease of ≥ 3 mL/min/1.73 m2 per year. The presence of kidney disease was defined as eGFR < 60 mL/min/1.73 m2 at baseline or proteinuria of higher than trace levels from two consecutive urine test results. Key Results: A total of 7246 participants were analyzed. The mean eGFR was 92.1 ± 14.0 mL/min/1.73 m2. Rapid eGFR decline was observed in 941 (13.0%) participants during a median follow-up of 11.7 years. When the participants were categorized into tertiles according to PWI-SF score, rapid eGFR decline was more prevalent in the group with the highest PWI-SF score (15.8%) than in the group with the lowest score (12.2%). Multivariate logistic regression analysis revealed that the risk of rapid eGFR decline was significantly increased in the tertile group with the highest PWI-SF score compared to the lowest group (odds ratio, 1.35; 95% confidence interval, 1.15–1.59). This association was maintained even after adjusting for confounding variables and excluding participants with kidney disease. Conclusions: Higher levels of psychosocial distress were closely associated with an increased risk of rapid kidney function decline.

Original languageEnglish
Pages (from-to)2966-2974
Number of pages9
JournalJournal of General Internal Medicine
Issue number10
Publication statusPublished - 2021 Oct

Bibliographical note

Funding Information:
The epidemiological data used in this study were obtained from the Korean Genome and Epidemiology Study (4851-302) of the National Research Institute of Health, Centers for Disease Control and Prevention, Ministry for Health and Welfare, Republic of Korea.

Publisher Copyright:
© 2021, Society of General Internal Medicine.

All Science Journal Classification (ASJC) codes

  • Internal Medicine


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