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TOPLINE:

Patients with chronic kidney disease (CKD) showed a 2.6-fold higher risk for depression requiring antidepressant treatment than those without CKD. The greatest risk was observed in those younger than 60 years.

METHODOLOGY:

• Depression is one of the most common psychiatric conditions in patients with CKD. However, evidence from large population-based studies on whether CKD increases the risk for depression requiring treatment is limited.
• Researchers conducted a retrospective cohort study using data from primary care practices in Germany between 2005 and 2022 to examine the association between CKD and the risk of developing depression requiring treatment.
• They included 165,787 patients (mean age, 71.6 years; 48.3% women) with CKD and matched them to control individuals without CKD using propensity score matching.
• Patients with schizophrenia, mood disorders, and neurotic disorders documented within 12 months prior to or on the date of the CKD diagnosis were excluded.
• The outcome was the diagnosis of depression within up to 10 years following the diagnosis of CKD; antidepressant prescriptions were evaluated in participants with a diagnosis of depression.

TAKEAWAY:

• The 10-year cumulative incidence of depression and depression followed by an antidepressant prescription was significantly higher in patients with CKD than in those without (P < .001 for both).
• Patients with CKD had a 2.6-fold higher risk for depression requiring antidepressant treatment than those without CKD (hazard ratio [HR], 2.63; P < .001), with the strongest effect found in those younger than 60 years (HR, 6.03; P < .001).
• Mirtazapine was the most commonly prescribed antidepressant in both CKD and non-CKD groups, followed by citalopram, opipramol, amitriptyline, and escitalopram.

IN PRACTICE:

"Our findings argue against strict screening protocols for the detection of depression in all patients with CKD. Though, some awareness should be raised for younger patients, given that depression risk was highest in this subgroup," the authors wrote.

SOURCE:

This study was led by Andreas Kommer, University Medical Center of the Johannes Gutenberg University, Mainz, Germany. It was published online on June 12, 2025, in Clinical Kidney Journal.

LIMITATIONS:

This study relied on diagnostic codes, which could have led to miscoding or undercoding. The database lacked information on how depression was diagnosed. Additionally, laboratory values were not available for every patient, making it impossible to track the progression of CKD and the initiation of renal replacement therapy.

DISCLOSURES:

This study did not receive any grant or funding. Two authors reported receiving support through the Clinician Scientist Fellowship, Else Kröner Research College. One author reported being an employee of IQVIA.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.