Biopsychosocial correlates of somatic symptom burden in chronic kidney disease: results of the Hamburg City Health Study (HCHS)

  1. Birte Jessen
  2. Bernd Löwe
  3. Raphael Twerenbold
  4. Martin Härter
  5. Volker Harth
  6. Hanno Hoven
  7. Christian Schmidt-Lauber
  8. Tobias B. Huber
  9. Meike Shedden-Mora
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Abstract

Background

Persistent somatic symptoms (PSS) in individuals with chronic kidney disease (CKD) occur across all stages and impact patients’ quality of life, morbidity and mortality. We aimed to unravel associations between biopsychosocial factors and symptom burden in individuals with CKD.

Methods

This cross-sectional study analysed individuals with CKD (estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m 2 ) from the first 10,000 participants of the population-based Hamburg City Health Study (HCHS). Somatic symptom burden (PHQ-15) was the primary outcome. Its association with potential biological (e.g., eGFR), psychological (e.g., depressive symptoms), and sociodemographic correlates was analysed in a multivariate prediction model. Correlates were compared to healthy controls and individuals with coronary heart disease (CHD).

Results

Somatic symptom burden in patients with non-dialysis CKD (n = 582, mean age: 69.58 years; 44.7% women; mean baseline eGFR: 52 mL/min/1.73m 2 ) increased with lower eGFR (r = -.161, p < .001). However, in a stepwise multiple linear regression model, eGFR was not correlated with symptom burden. In contrast, female sex, coronary heart disease, self-reported general health, proneness to illness, and depressive symptoms were associated with somatic symptom burden. Correlates of somatic symptom burden in patients with CHD (n = 618, mean age: 67.13 years; 24.1% women; mean baseline eGFR: 81 mL/min/1.73m 2 ) and matched healthy controls (n = 582, mean age: 69.58 years; 44.7% women; mean baseline eGFR: 81 mL/min/1.73m 2 ) were comparable.

Conclusion

Somatic symptom burden in CKD was only marginally related to the eGFR but rather to biopsychosocial factors. Therefore, taking a biopsychosocial perspective on PSS in CKD is important.

Key points

  • Kidney function (GFR) correlated with somatic symptom burden bivariately, but not in the multiple regression model.

  • Female sex, coronary heart disease, self-reported general health, proneness to illness and depressive symptoms correlated to symptom burden.

  • Similar biopsychosocial correlates of symptom burden were observed in individuals with CKD, coronary heart disease (CHD) and controls.

Article activity feed

  1. Version published to 10.1101/2025.11.27.25341140 on medRxiv