The Association of Posttraumatic Stress Disorder with Longitudinal Change in Glomerular Filtration Rate in World Trade Center Responders

Details

• Personal Author:
  Clouston SAP ; Coca SG ; Cohen BE ; Koraishy FM ; Kuan P-F ; Luft BJ ; Mann F ; Scherrer JF
• Description:
  Objective: High levels of psychological distress increase the risk of a wide range of medical diseases. In this study, we investigated the association between posttraumatic stress disorder (PTSD) and kidney disease. Methods: World Trade Center (WTC) responders were included if they had two or more measures of estimated glomerular filtration rate (eGFR). The PTSD Checklist (PCL) was used to define no PTSD (PCL < 40), "mild" PTSD (40 ≤ PCL <50), and "severe" PTSD (PCL ≥50). Subtypes of PTSD by symptom clusters were analyzed. Multinomial logistic regression was used to estimate the association of PTSD with two GFR change outcomes (decline or increase) compared with the stable GFR outcome. Results: In 2266 participants, the mean age was 53.1 years, 8.2% were female, and 89.1% were White. Individuals with PTSD (n = 373; 16.5%) did not differ in mean baseline GFR from individuals without PTSD (89.73 versus 90.56 mL min-1 1.73 m-2; p = .29). During a 2.01-year mean follow-up, a mean GFR decline of -1.51 mL min-1 1.73 m-2 per year was noted. In multivariable-adjusted models, PTSD was associated with GFR decline (adjusted relative risk [aRR] = 1.74 [1.32-2.30], p < .001) compared with stable GFR, with "hyperarousal" symptoms showing the strongest association (aRR =2.11 [1.40-3.19]; p < .001). Dose-response effects were evident when comparing mild with severe PTSD and comparing PTSD with versus without depression. PTSD was also associated with GFR rise (aRR = 1.47 [1.10-1.97], p < .009). The association between PTSD and GFR change was stronger in participants older than 50 years. Conclusions: PTSD may be a novel risk factor for exaggerated longitudinal GFR change in young, healthy adults. These findings need to be validated in other cohorts. [Description provided by NIOSH]
• Subjects:
  Emergency Responders Mental Health Nervous System Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: PTSD Depression First Responders GFR Kidney Disease Kidney Disorders Kidney Function Longitudinal Study Mental Health Post-traumatic Stress Disorder PTSD World Trade Center WTC

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• ISSN:
  0033-3174
• Document Type:
  Text
• Funding:
  Grant ; Contract
• Genre:
  Journal Article
• Place as Subject:
  California ; Missouri ; New York ; OSHA Region 2 ; OSHA Region 7 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  83
• Issue:
  9
• NIOSHTIC Number:
  nn:20070836
• Citation:
  Psychosom Med 2021 Nov/Dec; 83(9):978-986
• Contact Point Address:
  Farrukh M. Koraishy, MD, PhD, Department of Medicine/Nephrology, Stony Brook University Hospital, Health Science Center, Tower Level 16, Room 080 101 Nicolls Rd, Stony Brook, NY 11716-8166
• Email:
  Farrukh.Koraishy@stonybrookmedicine.edu
• Federal Fiscal Year:
  2022
• Performing Organization:
  State University of New York Stony Brook
• Peer Reviewed:
  True
• Start Date:
  20210701
• Source Full Name:
  Psychosomatic Medicine
• End Date:
  20230630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:00ed8f31b6859b821bcc3296f9d7793afd3c9134af1ad718784a7d1195fd88da44b00d3ff205741c904fd3be95d666c85c2a8bed1c401fcfb4ba5a23511d6aa0
• Download URL:
  https://stacks.cdc.gov/view/cdc/208982/cdc_208982_DS1.pdf
• File Type:
  [PDF - 414.04 KB ]