P0682PSYCHOLOGICAL STRESS AS A RISK FACTOR FOR RENAL FUNCTION DECLINE

Abstract

Abstract Background and Aims Accumulating evidences propose that psychological stress leads to changes in biological processes or behavioral patterns that effects disease risks. Supporting this possibility, recent animal experiments and population studies show a probable link between psychological stress and cardiovascular and metabolic diseases. However, the association between psychological stress and kidney function is not well elucidated yet. Method Data were retrieved from a prospective community-based cohort study (Korean Genome and Epidemiology Study). Psychological distress was assessed as the primary exposure using PWI-SF (psychosocial well-being index short form) scores. The decline rate of estimated glomerular filtration rate (eGFR) over time was calculated using linear regression analysis of serial eGFR measurements for each subject. Rapid eGFR decline was defined as an average decline in eGFR ≥3 ml/min/1.73 m2 per year. Results In total, 6,968 participants were analyzed. During a median follow-up of 10.49 years, rapid eGFR decline was observed in 886 (12.7%) participants. When the participants were categorized into tertiles according to PWI-SF score, rapid eGFR decline was more prevalent in the highest PWI-SF score group (14.0%) compared to the lowest PWI-SF score group (11.1%). Multivariate logistic regression analyses revealed that the risk of rapid eGFR decline was significantly increased in the highest PWI-SF score group compared to the lowest group (odds ratio, 2.04; 95% confidence interval 1.27-3.27). When PWI-SF score was treated as a continuous variable, each 1 standard deviation increase in PWI-SF was associated with a 12% increased risk of rapid eGFR decline. Conclusion The amount of psychological stress was significantly associated with an increased risk of rapid renal function decline in participants with normal renal function.