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ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Mental Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1536847
This article is part of the Research Topic Influence of Social Determinants on Wellbeing in Chronic Kidney Disease Patients View all articles
The mediating effect of depressive syndrome on the relationship between adverse childhood experiences and chronic kidney diseases among middle-aged and older adults
Provisionally accepted- 1 Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
- 2 West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- 3 Department of Psychiatry, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
BackgroundChronic kidney disease (CKD) is projected to rank among the top five causes of mortality by 2050. In addition to established risk factors, adverse childhood experiences (ACEs) have recently emerged as significant contributors to health risks, including CKD and depressive syndrome (DS). However, the mechanisms linking ACEs, DS, and CKD remain unclear. This study aims to explore the role of ACEs in CKD development, with a focus on the mediating effects of DS.MethodsThis retrospective cohort study analyzed data from 10,247 participants in the China Health and Retirement Longitudinal Study (CHARLS). Logistic regression models were applied to assess the associations between ACEs, DS, and incident CKD, adjusting for demographic and lifestyle factors. Mediation analysis was conducted to evaluate the role of DS in the relationship between ACEs and CKD.ResultsLogistic regression analysis indicated that participants with a history of ACEs were at higher risk for both DS and CKD. Mediation analysis demonstrated that DS partially mediated the associations between CKD and seven specific ACEs: physical abuse, household substance abuse, household mental illness, domestic violence, unsafe neighborhood, peer bullying, and parental disability. Notably, DS fully mediated the relationship between CKD and unsafe neighborhood.ConclusionsACEs significantly influence CKD risk in middle-aged and older adults, with DS serving as a key mediator. These findings underscore the importance of early mental health interventions and ACE-focused preventive strategies to reduce the burden of CKD.
Keywords: Adverse childhood experiences, Chronic Kidney Disease, Depression syndrome, Logistic regression, Mediation analysis
Received: 11 Dec 2024; Accepted: 21 Mar 2025.
Copyright: © 2025 Luo, Wang, Ran, Zhang, Li and Su. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Baihai Su, Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
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