Christine Liu, MD: Depression Coupled with Chronic Kidney Failure Daunting For Geriatric Patients

Geriatric patients with chronic kidney failure face many obstacles, including depression.

During the American Society of Nephrology (ASN) Kidney Week in Washington, D.C., Christine Liu, MD, assistant professor of Medicine at Boston University, explained how all these issues simultaneously impact geriatric patients.

MD Magazine: What is the impetus behind your study?

Liu: So, the impetus behind this study is I'm a geriatrician and so what geriatricians do is we specialize in the care of older adults.

Chronic kidney disease is highly prevalent in the older adult population and from what I know from my geriatrics training is that depression is also highly prevalent in the in the general populace in the general older population.

One of the things that we think about in geriatrics is the predominance of things we call geriatric conditions so things that are what we call multifactorial and affect quality of life. I wanted to look to see if depression and geriatric conditions could be somehow associated with each other in folks with chronic kidney disease.

MD Magazine: Do you believe the older patient is overlooked in the pursuit of new drugs to treat kidney problems?

Liu: I don't know if I would say if they are overlooked. I would say they are not the focus, even though they make up a large proportion of folks with either chronic kidney disease or end-stage kidney disease.

When you have an older adult, you have to pay attention to things like renal clearance processing by the liver and then also the burden for the patient.

So, thinking about the size of the pills, how many times a day you've got to take it and then also the expense and access to a new medication.

MD Magazine: How does the age of the patient and the depressive state worsen kidney failure?

Liu: I mean if you're depressed and you're older and for whatever reason if you're older and starting to lose your independence, it's harder for you to get out of the house.

You're going to that you're potentially going to be less likely to do anything that you need to do to reduce your kidney disease. So, meeting things like eat properly and control your diabetes, you know take your medicines.

I think you know as people age their worlds grow smaller and it really impacts therefore their outlook in life and their interaction with medical care.