title: Risk of major depression in patients with chronic renal failure on different treatment modalities: A matched-cohort and population-based study in Taiwan.
abstract: The influence of different treatment modalities on the risk of developing major depression in patients with chronic renal failure (CRF) is not well understood. We aimed to explore the incidence of major depression among patients with CRF who were on different dialysis modalities, who had received renal transplantation (RT), and those who had not yet received any of the aforementioned renal replacement therapies. We conducted a population-based retrospective cohort study using a national health insurance research database. This study investigated 89,336 study controls, 17,889 patients with chronic kidney disease on conservative treatment, 3823 patients on hemodialysis (HD), 351 patients on peritoneal dialysis (PD), and 322 patients who had RT. We followed all individuals until the occurrence of major depression or the date of loss to follow-up. The PD group had the highest risk (hazard ratio [HR] 2.43; 95% confidence interval [CI] 1.26-4.69), whereas the RT group had the lowest risk (HR 0.18; 95% CI 0.03-1.29) of developing major depression compared with the control group. Patients initiated on PD had a higher risk of developing major depression than patients initiated on HD (pairwise comparison: HR 2.20; 95% CI 1.09-4.46). Different treatment modalities are associated with different risks of developing major depression in patients with CRF. Among renal replacement therapies, patients who have had RT have the lowest risk of developing major depression. Patients who initiate renal therapy on PD may have a higher risk of major depression compared with patients who initiate renal therapy on HD.
authors.affiliation: Nephrology Department, New Taipei City Hospital, New Taipei City, Taiwan.|Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Chen
authors.affiliation: Psychiatry Department, Taipei City Hospital Jen-Ai Branch, Taipei, Taiwan.
authors.forename: I-Jen
authors.initials: IJ
authors.lastname: Wang
authors.affiliation: Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hui-Chu
authors.initials: HC
authors.lastname: Lang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000209:etiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology
keywords: Chronic kidney disease; hemodialysis; major depression; peritoneal dialysis; renal transplantation