Identifying and managing mental health problems in kidney disease patients. Can we do better?

02 May 2023

Dr Joe Chilcot is a psychologist from King’s College London who is interested in how long-term conditions can impact mental health, with a particular focus on chronic kidney disease (CKD) patients. With support from Kidney Research UK-Stoneygate project grant, Joe and his team are investigating how well depression is identified and managed in those living with CKD.

Dr Joe Chilcott

Depression and CKD: what do we know so far?

Depression affects around 5% of the UK population at any given time. With current tools it has been tricky to get a good estimate for the rates of depression in kidney patients. Combining the figures from many studies of self-reported and diagnosed depression, this could be impacting 27% of people with CKD, 27% of kidney transplant recipients and 39.3% of those on dialysis.

Joe's previous research has shown that depression can be difficult to diagnose in CKD patients due to overlapping symptoms, so numbers may in fact be higher. Attempts have been made to improve diagnosis and treatment of depression in this patient group, but there has been little research into how effective current approaches are. This study aimed to find out how depression is currently identified and managed in patients living with CKD.

Learnings from Joe’s study

Joe and his team reviewed results from 860 research papers relating to depression and CKD. They found that although there have been lots of studies published in this area, many important questions remain unanswered and there is a particularly concerning lack of research on depression in transplant recipients.

Joe’s team also found that we need more studies on how well different treatments work in CKD patients, and additional research is required to find out if identification and management of depression varies between different hospitals and care settings. Importantly, this research also found that that the diversity of the CKD population was not well represented in the published studies.

Joe added, “Our Moodmaps study is moving to the next phases, building on the work we have already done. It is vital that we understand where the gaps in mental health provision are so we can make some recommendations about how to improve support for people living with kidney disease and identify future research priorities.”

Working towards a better future for CKD patients

The team led by Joe have highlighted the need for better identification and reporting of depression in those living with CKD. Currently we are not sure how well renal services, GPs and other healthcare professionals screen for depression in this group and whether this done routinely. With colleagues from across the UK, Joe’s on-going project (Moodmaps study) hopes to be able to answer some of these questions. Going forward there is a need for much more research to understand which treatments for depression are acceptable and effective in people living with kidney disease and how this might be offered to all people who need support.

Jo Pywell, partnerships and programme manager for mental health at Kidney Research UK commented “The ongoing research by Joe and his team is an important step towards improving mental health care provision for kidney disease patients. We recognise the challenges in this area and are committed to investing in research to meet this need with the release of our mental health report planned for May 2023.”