慢性肾脏病患者焦虑和抑郁状态的研究进展
Research Progress on the State of Anxiety and Depression in Patients with Chronic Kidney Disease
DOI: 10.12677/acm.2026.1652034, PDF,    科研立项经费支持
作者: 赵欣蕾:昆明医科大学第二临床医学院,云南 昆明;杨 敏*:昆明医科大学第二附属医院肾脏内科,云南 昆明
关键词: 慢性肾脏病焦虑抑郁Chronic Kidney Disease Anxiety Depression
摘要: 慢性肾脏病患者焦虑和抑郁的发生率逐渐升高,其防治面临重大挑战。但目前临床上多注重对慢性肾脏病的治疗,忽视对焦虑抑郁的筛查、治疗,影响患者生存质量以及预后。故本文献综述慢性肾脏病患者焦虑和抑郁的患病情况、发病机制和治疗新进展,旨在为今后CKD患者并发焦虑抑郁的预防和制定个性化干预研究提供参考和依据。
Abstract: The incidence of anxiety and depression in patients with chronic kidney disease is increasing, posing significant challenges for its prevention and treatment. However, current clinical practices often emphasize the treatment of chronic kidney disease while overlooking the screening and management of anxiety and depression, which negatively impact patients’ quality of life and prognosis. Therefore, it is imperative to investigate the prevalence, pathogenesis, and therapeutic advancements in anxiety and depression among chronic kidney disease patients thereby providing insights and evidence for the prevention and personalized intervention strategies for these comorbid conditions in the future.
文章引用:赵欣蕾, 杨敏. 慢性肾脏病患者焦虑和抑郁状态的研究进展[J]. 临床医学进展, 2026, 16(5): 2241-2247. https://doi.org/10.12677/acm.2026.1652034

参考文献

[1] 中华预防医学会肾脏病预防与控制专业委员会. 中国慢性肾脏病早期评价与管理指南[J]. 中华内科杂志, 2023, 62(8): 902-930.
[2] GBD 2023 Chronic Kidney Disease Collaborators (2025) Global, Regional, and National Burden of Chronic Kidney Disease in Adults, 1990-2023, and Its Attributable Risk Factors: A Systematic Analysis for the Global Burden of Disease Study 2023. The Lancet, 406, 2461-2482.
[3] Huang, C.W., Wee, P.H., Low, L.L., Koong, Y.L.A., Htay, H., Fan, Q., et al. (2021) Prevalence and Risk Factors for Elevated Anxiety Symptoms and Anxiety Disorders in Chronic Kidney Disease: A Systematic Review and Meta-Analysis. General Hospital Psychiatry, 69, 27-40. [Google Scholar] [CrossRef] [PubMed]
[4] Alshelleh, S., Alhouri, A., Taifour, A., Abu-Hussein, B., Alwreikat, F., Abdelghani, M., et al. (2022) Prevelance of Depression and Anxiety with Their Effect on Quality of Life in Chronic Kidney Disease Patients. Scientific Reports, 12, Article No. 17627. [Google Scholar] [CrossRef] [PubMed]
[5] Palmer, S., Vecchio, M., Craig, J.C., Tonelli, M., Johnson, D.W., Nicolucci, A., et al. (2013) Prevalence of Depression in Chronic Kidney Disease: Systematic Review and Meta-Analysis of Observational Studies. Kidney International, 84, 179-191. [Google Scholar] [CrossRef] [PubMed]
[6] Zhang, Z., He, P., Liu, M., Zhou, C., Liu, C., Li, H., et al. (2021) Association of Depressive Symptoms with Rapid Kidney Function Decline in Adults with Normal Kidney Function. Clinical Journal of the American Society of Nephrology, 16, 889-897. [Google Scholar] [CrossRef] [PubMed]
[7] Patel, N.M., Kataria, L.R., Sarvaiya, D.C., Joshi, H.K., Jain, A. and Kalathiya, P.M. (2025) Prevalence, Psychosocial, and Medical Correlates of Anxiety and Depression in Patients with Chronic Kidney Disease. Industrial Psychiatry Journal, 34, 421-427. [Google Scholar] [CrossRef
[8] 张宇, 赵卫红, 裴小华, 雍珍珠, 张娟. 慢性肾脏病患者焦虑抑郁状况的调查[J]. 中华老年多器官疾病杂志, 2019, 18(11): 845-849.
[9] Holloway, A.L. and Lerner, T.N. (2024) Hidden Variables in Stress Neurobiology Research. Trends in Neurosciences, 47, 9-17. [Google Scholar] [CrossRef] [PubMed]
[10] Kelly, D.M., Kelleher, E.M. and Rothwell, P.M. (2025) The Kidney-Immune-Brain Axis: The Role of Inflammation in the Pathogenesis and Treatment of Stroke in Chronic Kidney Disease. Stroke, 56, 1069-1081. [Google Scholar] [CrossRef] [PubMed]
[11] Beurel, E., Toups, M. and Nemeroff, C.B. (2020) The Bidirectional Relationship of Depression and Inflammation: Double Trouble. Neuron, 107, 234-256. [Google Scholar] [CrossRef] [PubMed]
[12] Lefrère, A., Burtey, S., Bobot, S., Belzeaux, R. and Bobot, M. (2025) Depression in Chronic Kidney Disease: Particularities, Specific Mechanisms and Therapeutic Considerations, a Narrative Review. Behavioural Brain Research, 483, Article 115467. [Google Scholar] [CrossRef] [PubMed]
[13] Francis, H.M., Stevenson, R.J., Tan, L.S.Y., Ehrenfeld, L., Byeon, S., Attuquayefio, T., et al. (2022) Kynurenic Acid as a Biochemical Factor Underlying the Association between Western-Style Diet and Depression: A Cross-Sectional Study. Frontiers in Nutrition, 9, Article 945538. [Google Scholar] [CrossRef] [PubMed]
[14] Karbowska, M., Hermanowicz, J.M., Tankiewicz-Kwedlo, A., Kalaska, B., Kaminski, T.W., Nosek, K., et al. (2020) Neurobehavioral Effects of Uremic Toxin-Indoxyl Sulfate in the Rat Model. Scientific Reports, 10, Article No. 9483. [Google Scholar] [CrossRef] [PubMed]
[15] Sun, C.Y., Li, J.R., Wang, Y.Y., Lin, S.Y., et al. (2021) Indoxyl Sulfate Caused Behavioral Abnormality and Neurodegeneration in Mice with Unilateral Nephrectomy. Aging, 13, 6681-6701. [Google Scholar] [CrossRef] [PubMed]
[16] Adesso, S., Paterniti, I., Cuzzocrea, S., Fujioka, M., Autore, G., Magnus, T., et al. (2018) AST-120 Reduces Neuroinflammation Induced by Indoxyl Sulfate in Glial Cells. Journal of Clinical Medicine, 7, Article 365. [Google Scholar] [CrossRef] [PubMed]
[17] Sun, C.Y., Li, J.R., Wang, Y.Y., Lin, S.Y., et al. (2020) p-Cresol Sulfate Caused Behavior Disorders and Neurodegeneration in Mice with Unilateral Nephrectomy Involving Oxidative Stress and Neuroinflammation. International Journal of Molecular Sciences, 21, Article 6687. [Google Scholar] [CrossRef] [PubMed]
[18] Needham, B.D., Funabashi, M., Adame, M.D., Wang, Z., Boktor, J.C., Haney, J., et al. (2022) A Gut-Derived Metabolite Alters Brain Activity and Anxiety Behaviour in Mice. Nature, 602, 647-653. [Google Scholar] [CrossRef] [PubMed]
[19] Lane, M.M., Gamage, E., Du, S., Ashtree, D.N., McGuinness, A.J., Gauci, S., et al. (2024) Ultra-Processed Food Exposure and Adverse Health Outcomes: Umbrella Review of Epidemiological Meta-Analyses. British Medical Journal, 384, e077310. [Google Scholar] [CrossRef] [PubMed]
[20] Liu, M., Zhang, Y., Yang, S., Wu, Q., Ye, Z., Zhou, C., et al. (2022) Bidirectional Relations between Depression Symptoms and Chronic Kidney Disease. Journal of Affective Disorders, 311, 224-230. [Google Scholar] [CrossRef] [PubMed]
[21] Damba, J.J., Bodenstein, K., Lavin, P., Drury, J., Sekhon, H., Renoux, C., et al. (2022) Psychotropic Drugs and Adverse Kidney Effects: A Systematic Review of the Past Decade of Research. CNS Drugs, 36, 1049-1077. [Google Scholar] [CrossRef] [PubMed]
[22] Qaseem, A., Owens, D.K., Etxeandia-Ikobaltzeta, I., Tufte, J.E., Cross, J.T., Wilt, T.J., et al. (2024) Nonpharmacologic and Pharmacologic Treatments of Adults in the Acute Phase of Major Depressive Disorder: A Living Clinical Guideline from the American College of Physicians (Version 1, Update Alert 2). Annals of Internal Medicine, 177, eL230440. [Google Scholar] [CrossRef] [PubMed]
[23] National Institute for Health and Care Excellence (2022) Guidelines. Depression in Adults: Treatment and Management. National Institute for Health and Care Excellence (NICE).
[24] Kopcalic, K., Arcaro, J., Pinto, A., Ali, S., Barbui, C., Curatoli, C., et al. (2025) Antidepressants versus Placebo for Generalised Anxiety Disorder (GAD). Cochrane Database of Systematic Reviews, 2025, CD012942. [Google Scholar] [CrossRef] [PubMed]
[25] Garakani, A., Buono, F.D., Salehi, M., Funaro, M.C., Klimowicz, A., Sharma, H., et al. (2024) Antipsychotic Agents in Anxiety Disorders: An Umbrella Review. Acta Psychiatrica Scandinavica, 149, 295-312. [Google Scholar] [CrossRef] [PubMed]
[26] 黄尚岗. 认知行为疗法干预治疗老年抑郁症的研究进展[J]. 中国卫生标准管理, 2023, 14(1): 195-198.
[27] Cuijpers, P., van Straten, A., Andersson, G. and van Oppen, P. (2008) Psychotherapy for Depression in Adults: A Meta-Analysis of Comparative Outcome Studies. Journal of Consulting and Clinical Psychology, 76, 909-922. [Google Scholar] [CrossRef] [PubMed]
[28] 陶晶晶, 陈芳, 裴大军, 代雅琪. 正念减压疗法在慢性病患者中的研究进展[J]. 职业与健康, 2017, 33(11): 1580-1584.
[29] Heissel, A., Heinen, D., Brokmeier, L.L., Skarabis, N., et al. (2023) Exercise as Medicine for Depressive Symptoms? A Systematic Review and Meta-Analysis with Meta-Regression. British Journal of Sports Medicine, 57, 1049-1057. [Google Scholar] [CrossRef] [PubMed]
[30] Zhou, X., Bai, Y., Zhang, F. and Gu, M. (2024) Exercise and Depression Symptoms in Chronic Kidney Disease Patients: An Updated Systematic Review and Meta-Analysis. Renal Failure, 46, Article 2436105. [Google Scholar] [CrossRef] [PubMed]
[31] Glorieux, G., Burtey, S., Evenepoel, P., Jankowski, J., Koppe, L., Masereeuw, R., et al. (2026) A Guide to Uraemic Toxicity. Nature Reviews Nephrology, 22, 50-68. [Google Scholar] [CrossRef
[32] Faria, M. and de Pinho, M.N. (2021) Challenges of Reducing Protein-Bound Uremic Toxin Levels in Chronic Kidney Disease and End Stage Renal Disease. Translational Research, 229, 115-134. [Google Scholar] [CrossRef] [PubMed]
[33] Fiorentino, M., La Fergola, F. and De Rosa, S. (2024) Medium Cut-Off Dialyzer for Middle Molecular Uremic Toxins in AKI and Chronic Dialysis. Journal of Nephrology, 37, 23-37. [Google Scholar] [CrossRef] [PubMed]