Predictors of Social Frailty and Depression in Brazilian Patients With Chronic Kidney Disease: A Cross‐Sectional Study

BACKGROUND: Social frailty is linked to adverse health outcomes, including depression, especially in older and chronically ill individuals. This study aimed to assess the prevalence and associated factors of social frailty in Brazilian CKD patients undergoing hemodialysis or kidney transplantation and to examine its predictive role in the development of depressive symptoms. METHODS: This cross-sectional, correlational, and comparative study included 284 patients with CKD from São Paulo, Brazil. Data were collected using validated instruments: HALFT Social Frailty Scale, Patient Health Questionnaire-9 (PHQ-9), and Medical Outcomes Study Social Support Scale (MOS). Two multiple linear regression (MLR) models were used to assess predictors of social frailty and depressive symptoms, adjusting for sociodemographic and clinical variables. RESULTS: Social frailty was significantly more prevalent among HD patients (51.2%) compared to TX patients (24%). Social support was negatively associated with social frailty (β = -0.40; p < 0.001). Other predictors of greater social frailty included lower income (β = 0.51 for ≤ 1 minimum wage), number of medications (β = 0.11), and lower education (β = -0.13). In turn, social frailty was the strongest predictor of depressive symptoms (β = 0.60; p < 0.001). TX status and male sex were associated with lower depression scores. CONCLUSION: Social frailty is highly prevalent in CKD patients, particularly those undergoing HD, and strongly predicts depressive symptoms. Strategies to enhance social support and reduce socioeconomic vulnerability may help mitigate mental health burdens in this population.