Depression but not anxiety is associated with iron deficiency anemia for patients with stage 2-4 CKD

Background: Chronic kidney disease (CKD) is a global health challenge, often complicated by iron deficiency anemia (IDA), depression, and anxiety. While the impact of IDA on depression has been well-documented, its association with anxiety in non-dialysis-dependent CKD patients remains unclear. This study aimed to investigate the relationship between IDA and neuropsychiatric disorders, specifically depression and anxiety, in patients with non-dialysis-dependent CKD stages 2-4. Methods: A cross-sectional study was conducted in the outpatient nephrology clinic at Gazi University Hospital, enrolling 200 patients with stable CKD (stages 2-4). Depression and anxiety were measured using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), respectively. Statistical analysis included comparisons of BDI and BAI scores between anemic and non-anemic groups, along with subgroup analysis of iron-treated anemic patients. Results: Anemia was present in 38% of patients, and anemic patients had significantly higher BDI scores (mean 13.4 vs. 9.0, p<0.001) than non-anemic patients, indicating a greater prevalence of depressive symptoms. No significant differences were found in BAI scores between the groups. However, anemic patients receiving iron supplementation had lower BDI and BAI scores compared to untreated anemic patients (p<0.001). Conclusions: IDA was associated with a higher prevalence of depression but not anxiety in non-dialysis CKD patients. Iron supplementation may help mitigate depressive symptoms in this population. Further prospective studies are needed to explore the full potential of iron therapy in managing mental health outcomes in CKD patients.