Key result
Biopsychosocial factors like depression, rather than eGFR, link to somatic symptom burden in CKD.
Why the study?
Persistent somatic symptoms occur across all CKD stages and affect quality of life and mortality, but their associations with biopsychosocial factors were not well established.
Cross-Sectional (n=1,782)
No
Effect estimate: r = -0.161
p-value: p=< .001
Somatic symptom burden in patients with chronic kidney disease is primarily driven by biopsychosocial factors such as depression and self-reported health rather than the severity of renal impairment.
Biopsychosocial assessment may warrant priority in non-dialysis CKD; challenges eGFR primacy but remains hypothesis-generating.
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 (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 were compared to those 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 ). Self-reported general health and depression were associated with somatic symptom burden in all groups, while there were specific correlates in the CHD (e.g. age) and the healthy control group (e.g. expectancy of deterioration of health status). Conclusions: 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.
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Jessen et al. (2026) conducted a cross-sectional in Chronic kidney disease (n=1,782). Biopsychosocial factors and eGFR vs. Healthy controls and individuals with coronary heart disease was evaluated on Somatic symptom burden (PHQ-15) (r = -0.161, p=< .001). Lower eGFR was univariately correlated with increased somatic symptom burden in non-dialysis CKD (r = -0.161, p < 0.001), but biopsychosocial factors were the primary independent correlates.
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