Coping Behaviors and Incident Kidney Disease

KEY POINTS: Adaptive coping behaviors are associated with lower odds of incident CKD. Coping behaviors could represent a target to prevent CKD. BACKGROUND: How someone copes may alter the trajectory of their kidney function. We aimed to evaluate whether coping behaviors were associated with incident CKD or rapid kidney function decline. METHODS: We used data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study (Baltimore, MD) for this longitudinal analysis. Adaptive and maladaptive coping behavioral constructs were measured using the Brief COPE Inventory at visit 1. We used multiple logistic regression to assess the odds of incident CKD and rapid kidney function decline per point increase in coping scales and adjusted for baseline demographics and clinical variables. RESULTS: Of 1935 participants, mean age was 48 years, 44% were male, 56% were Black persons, and baseline mean (SD) eGFR was 91 (16) ml/min per 1.73 m(2). After a median of 8.2 years, 113 participants developed incident CKD and 341 had rapid kidney function decline. Compared with those who reported they usually did not use adaptive coping behaviors at all (such as emotional support), those with the highest use of adaptive coping had lower odds of incident CKD. Every 1-unit increase in adaptive coping corresponded with a 2% lower adjusted odds of incident CKD (odds ratio, 0.98; 95% confidence interval, 0.95 to 0.99). There was no association between maladaptive coping behaviors and incident CKD. Coping behaviors were not associated with rapid kidney function decline. CONCLUSIONS: Adaptive coping behaviors were associated with lower odds of incident CKD and could represent a target to facilitate CKD prevention. The role of medical care in this association is an area worthy of further investigation.