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Inflammation and Response to Sertraline Treatment in Patients With CKD and Major Depression

Published:December 19, 2019DOI:https://doi.org/10.1053/j.ajkd.2019.09.007
      Depression affects 20% of patients with chronic kidney disease (CKD) and is associated with dialysis initiation, hospitalization, and death.
      • Hedayati S.S.
      • Minhajuddin A.T.
      • Toto R.D.
      • Morris D.W.
      • Rush A.J.
      Prevalence of major depressive episode in CKD.
      • Hedayati S.S.
      • Minhajuddin A.T.
      • Afshar M.
      • Toto R.D.
      • Trivedi M.H.
      • Rush A.J.
      Association between major depressive episodes in patients with chronic kidney disease and initiation of dialysis, hospitalization, or death.
      • Palmer S.C.
      • Vecchio M.
      • Craig J.C.
      • et al.
      Association between depression and death in people with CKD: a meta-analysis of cohort studies.
      In the Chronic Kidney Disease Antidepressant Sertraline Trial (CAST), treatment with sertraline vs placebo did not improve depressive symptoms in patients with CKD not requiring kidney replacement therapy and major depressive disorder (MDD).
      • Hedayati S.S.
      • Gregg L.P.
      • Carmody T.
      • et al.
      Effect of sertraline on depressive symptoms in patients with chronic kidney disease without dialysis dependence: the CAST randomized clinical trial.
      Patients with CKD have enhanced systemic inflammation, which has been proposed as a mediator of depression in chronic medical illnesses.
      • Hedayati S.S.
      • Minhajuddin A.T.
      • Toto R.D.
      • Morris D.W.
      • Rush A.J.
      Prevalence of major depressive episode in CKD.
      ,
      • Leonard B.E.
      Inflammation and depression: a causal or coincidental link to the pathophysiology?.
      • Rutledge T.
      • Reis V.A.
      • Linke S.E.
      • Greenberg B.H.
      • Mills P.J.
      Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes.
      • Akchurin O.M.
      • Kaskel F.
      Update on inflammation in chronic kidney disease.
      It is unknown whether inflammatory biomarkers predict sertraline response in patients with CKD.
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