What is the clinical evidence from this study?

Study design: Cohort. Population: Nondialysis-Dependent Chronic Kidney Disease (CKD) (n=598153). Intervention: Depression vs. No depression. Primary outcome: All-cause mortality (HR 1.25, 95% CI 1.23-1.26, p=<0.001).

August 17, 2012Clinical Journal of the American Society of NephrologyOpen Access

Association of Depression and Antidepressant Use with Mortality in a Large Cohort of Patients with Nondialysis-Dependent CKD

Q: What are the key findings of this study?

Depression and antidepressant use were associated with a significantly higher risk of all-cause mortality (HR 1.25) in patients with nondialysis-dependent chronic kidney disease, independent of comorbid conditions.

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Key result

Depression and antidepressant use were associated with a significantly higher risk of all-cause mortality (HR 1.25) in patients with nondialysis-dependent chronic kidney disease, independent of comorbid conditions.

Why the study?

Is depression associated with increased all-cause mortality in patients with nondialysis-dependent CKD?

Population

n=598,153 US veterans with nondialysis-dependent CKD stages 1-5, predominantly elderly male

Comparison

Diagnosis of depression vs No diagnosis of depression

Design

Cohort

Follow-up

median 4.7 years

Authors

RBRasheed A. BalogunUniversity of Virginia Health System EAEmaad M. Abdel‐RahmanUniversity of Virginia Health System SBSeki A. BalogunOklahoma City University

Discussion

Member takes

Implication

Supports depression screening in nondialysis CKD; leaves open whether treatment modifies mortality.

Study Design

Type

Cohort (n=598,153)

Multicenter

Yes

Structured PICO

Is depression associated with increased all-cause mortality in patients with nondialysis-dependent CKD?

Population

598,153 predominantly male US veterans with nondialysis-dependent chronic kidney disease stages 1-5, followed for a median of 4.7 years.

Exposure

Diagnosis of depression (established by systematic screening and administration of antidepressants)

Comparator

No diagnosis of depression

Outcome

All-cause mortalityhard clinical

Main Result

Hazard Ratio: 1.25 (95% CI 1.23–1.26)

p-value: p=<0.001

In a large cohort of US veterans with nondialysis-dependent CKD, depression was highly prevalent (30%) and independently associated with a 25% increased risk of all-cause mortality.

Limitations

Observational nature allows only for inference of associations, not causality.
Most depression diagnoses were based on antidepressant use, which may have been prescribed for other indications.
Predominantly male veteran population may limit generalizability to women and nonveterans.
Potential underdiagnosis of comorbidities.
Selection bias related to the limited availability of urine microalbumin measurements for defining CKD stages 1 and 2.

Cite This Study

Balogun et al. (2012) conducted a cohort in Nondialysis-Dependent Chronic Kidney Disease (CKD) (n=598,153). Depression vs. No depression was evaluated on All-cause mortality (HR 1.25, 95% CI 1.23-1.26, p=<0.001). Depression and antidepressant use were associated with a significantly higher risk of all-cause mortality (HR 1.25) in patients with nondialysis-dependent chronic kidney disease, independent of comorbid conditions.

synapsesocial.com/papers/6a1f17a0ac5208ccbd729464 https://doi.org/10.2215/cjn.02650312

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August 17, 2012Clinical Journal of the American Society of NephrologyOpen Access

Association of Depression and Antidepressant Use with Mortality in a Large Cohort of Patients with Nondialysis-Dependent CKD

View Full Paper

Ask AI

Bookmark

Key result

Why the study?

Is depression associated with increased all-cause mortality in patients with nondialysis-dependent CKD?

Population

n=598,153 US veterans with nondialysis-dependent CKD stages 1-5, predominantly elderly male

Comparison

Diagnosis of depression vs No diagnosis of depression

Design

Cohort

Follow-up

median 4.7 years

Authors

RBRasheed A. BalogunUniversity of Virginia Health System EAEmaad M. Abdel‐RahmanUniversity of Virginia Health System SBSeki A. BalogunOklahoma City University

Discussion

Member takes

Implication

Supports depression screening in nondialysis CKD; leaves open whether treatment modifies mortality.

Study Design

Type

Cohort (n=598,153)

Multicenter

Yes

Structured PICO

Is depression associated with increased all-cause mortality in patients with nondialysis-dependent CKD?

Population

598,153 predominantly male US veterans with nondialysis-dependent chronic kidney disease stages 1-5, followed for a median of 4.7 years.

Exposure

Diagnosis of depression (established by systematic screening and administration of antidepressants)

Comparator

No diagnosis of depression

Outcome

All-cause mortalityhard clinical

Main Result

Hazard Ratio: 1.25 (95% CI 1.23–1.26)

p-value: p=<0.001

In a large cohort of US veterans with nondialysis-dependent CKD, depression was highly prevalent (30%) and independently associated with a 25% increased risk of all-cause mortality.

Limitations

Observational nature allows only for inference of associations, not causality.
Most depression diagnoses were based on antidepressant use, which may have been prescribed for other indications.
Predominantly male veteran population may limit generalizability to women and nonveterans.
Potential underdiagnosis of comorbidities.
Selection bias related to the limited availability of urine microalbumin measurements for defining CKD stages 1 and 2.

Cite This Study

synapsesocial.com/papers/6a1f17a0ac5208ccbd729464 https://doi.org/10.2215/cjn.02650312

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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