Charlotte Robinson

DocwireNews

Patients with CKD commonly experience depression, putting them at risk for a poor prognosis. The use of antidepressants in the population with CKD is widespread. However, according to Nanbo Zhu and colleagues, there are few data available on the safety of those agents in patients with CKD.&nbsp;Dr. Zhu et al conducted an analysis that included data on adults with stage 3-5 CKD (eGFR &lt;60 mL/min/1.73 m2 not treated with dialysis) and a diagnosis of incident depression from 2007 to 2019. The data were included in the Stockholm Creatinine Measurements project. The researchers compared three treatment strategies using the target trial emulation framework: (1) initiating versus not initiating antidepressants; (2) initiating mirtazapine versus selective serotonin reuptake inhibitors (SSRIs); and (3) initiating SSRIs with a lower dose versus a standard dose.&nbsp;The dataset included 7798 eligible individuals. Of those, 74% (n=5743) initiated treatment with an antidepressant. Compared with noninitiation, there was an association between initiation of antidepressants with higher hazards of short-term outcomes: hip fracture (hazard ratio [HR], 1.23; 95% CI, 0.88-1.74) and upper gastrointestinal bleeding (HR, 1.38; 95% CI, 0.82-2.31). The associations did not reach statistical significance. There was no association between initiation of anti-depressants and the long-term outcomes of all-cause mortality, major adverse cardiovascular events, progression of CKD, and suicidal behavior.&nbsp;Compared with SSRIs, there was an association between initiation of mirtazapine and lower hazard of upper gastrointestinal bleeding (HR, 0.52; 95% CI, 0.29-0.96). However, there was also an association between initiation of mirtazapine and a higher hazard of mortality (HR, 1.11; 95% CI, 1.00-1.22). Compared with the standard dose, there was a nonstatistically significant association between initiation of SSRIs at a lower dose and a lower hazard of upper gastrointestinal bleeding (HR, 0.68; 95% CI, 0.35-1.34) and progression of CKD (HR, 0.80; 95% CI, 0.63-1.02). There was also a nonstatistically significant association with a lower dose of SSRIs and a higher hazard of cardiac arrest (HR, 2.34; 95% CI, 1.02-5.40).&nbsp;&ldquo;Antidepressant treatment was associated with short-term adverse outcomes but not long-term outcomes in people with CKD and depression,&rdquo; the authors said.&nbsp;Source: <a href="https://www.doi.org/10.2215/CJN.0000000000000348" target="_blank" rel="noopener">Clinical Journal of the American Society of Nephrology</a>&nbsp;

Jayme Locke, MD, MPH

Joel M. Topf, MD, FACP

The Promise of Xenotransplantation

NKF Spring Clinical Meetings 2025

Leah Lawrence

Real-World Data Backs Invasive DFS as Surrogate Endpoint for OS in EBC

HR Breast Cancer

Sacituzimab Govitecan Showed Modest Activity for CNS Metastases

Triple-Negative Breast Cancer

Latest News

Antidepressants in Patients With CKD and Depression

Chronic Kidney Disease

Use of antidepressants among patients with chronic kidney disease (CKD) is widespread but few data are available on their safety in this population.

Antidepressants in Patients With CKD and Depression 

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe