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一项关于抑郁症和慢性病之间的双向关联的回顾性队列研究
Ki Jin Jeun1, Todd Brothers2, Khaled Shawwa3
1Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, United States.
Frontiers in nephrology
|January 21, 2026
概括
抑郁加速慢性病 (CKD) 的进展. 患有5期CKD的患者面临患有抑郁症的最高风险,这凸显了CKD护理中综合心理健康查的需要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 精神病学是一个精神病学.
- 流行病学 流行病学
背景情况:
- 抑郁症与慢性病 (CKD) 的不良结果有关.
- 抑郁症对CKD进展的影响,特别是在早期阶段,需要进一步研究.
- 了解抑郁症和CKD之间的双向关系对于患者管理至关重要.
研究的目的:
- 调查抑郁症在CKD不同阶段进展中的作用.
- 通过使用现实世界的数据,检查抑郁症和CKD之间的双向关系.
- 为了确定与抑郁症诊断风险增加相关的特定CKD阶段.
主要方法:
- 电子医疗记录的回顾性队列分析 (TriNetX数据库,2007-2022年).
- 包括被诊断患有CKD的成年患者.
- 独立变量包括抑郁/焦虑 (ICD代码) 和CKD阶段 (KDIGO). 主要结局:病进展 (eGFR<60毫升/分钟/个体每天或>40%的下降). 二次结果:抑郁症的诊断. 分析:卡普兰-梅尔,考克斯的比例危险,调整为共变量.
主要成果:
- 抑郁症显著增加病进展的风险 (HR=1.94,p<0.001).
- 患有CKD第4期和第5期的患者与≤3期 (HR=1.26和1.38,分别p<0.001) 相比,显著增加了新的抑郁症诊断的风险.
- 在调整了年龄,性别,种族和并发症后,这些关联仍然很重要.
结论:
- 抑郁加速了CKD的进展.
- 第五期CKD患者患抑郁症的风险最高.
- 建议经常对CKD患者进行心理健康查,以改善结果并减轻抑郁症的负面影响.
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