Chronic kidney disease is associated with incident depression requiring treatment: a retrospective cohort study

Depression is one of the most common psychiatric condition in patients with chronic kidney disease (CKD). It is associated with decreased adherence and quality of life as well as increased risk for dialysis, hospitalization, and mortality. Large population-based analysis evaluating the effect of CKD on the incidence of depression are missing.

We performed a retrospective cohort study investigating the incidence of depression after CKD diagnosis in a large cohort derived from the IQVIA^TM Disease Analyzer database. Patients with CKD were matched to individuals without CKD using the nearest neighbor propensity score matching method. The 10-year cumulative incidence of depression was compared between the cohorts using Kaplan-Meier curves and an univariable conditional Cox regression analysis was performed to assess the association between CKD and depression, as well as antidepressant prescription.

Both cohorts included 165 787 individuals each, either with or without CKD. The 10-year incidence of depression was 24.2% in patients with CKD and 22.2% in patients without CKD (P < .001). The incidence of depression followed by an antidepressant prescription was 9.0% in the CKD cohort and 3.5% in the non-CKD cohort (P < .001), resulting in a hazard ratio (HR) of 2.63 (95% confidence intervals (CI) 2.51-2.75). This association was strongest in younger patients below 60 years of age (HR 6.03, 95% CI 5.17-7.01).

In this large cohort, CKD is associated with a slightly higher incidence of depression requiring drug treatment. Clinicians caring for patients with CKD, especially younger patients, should be aware of the increased risk.