| アブストラクト | BACKGROUND: Although the risk of depression is well-known in the patients with kidney dysfunction, especially at the late stages, little is known about the exact point at which the decline in estimated glomerular filtration rate (eGFR) begins to significantly increase the risk of depression. In the present study, we analysed a nationwide epidemiological dataset to investigate the dose-dependent association between baseline eGFR and a future risk of developing depression in a general population. METHODS: We retrospectively analysed 1,518,885 individuals (male: 46.3%) without a history of depression identified between April 2014 and November 2022 within a nationwide epidemiological database, provided by DeSC Healthcare (Tokyo, Japan). We investigated the association of eGFR with the incidence of depression using Cox regression analyses and also conducted cubic spline analysis to investigate the dose-dependent association between eGFR and depression. RESULTS: In the mean follow-up of 1218 +/- 693 days, 45,878 cases (3.0% for total participants, 2.6% for men and 3.3% for women) of depression were recorded. The risk of depression increased with the eGFR decline as well as the presence of proteinuria. Multivariable Cox regression analysis showed the hazard ratio (95% CI) of depression in each kidney function category (eGFR >/=90, 60-89, 45-59, 30-44, 15-29, and < 15 mL/min/1.73 m(2)) was 1.14 (1.11-1.17), 1 (reference), 1.11 (1.08-1.14), 1.51 (1.43-1.59), 1.77 (1.57-1.99) and 1.77 (1.26-2.50), respectively. In the cubic spline analysis, the risk of depression continued to increase monotonically as the eGFR declined when the eGFR fell below approximately 65 mL/min/1.73 m(2). CONCLUSIONS: Our analysis using a large-scale epidemiological dataset presented the dose-dependent association between eGFR decline and the risk of depression, which highlights the importance of incorporating mental health assessments into the routine care of patients with kidney dysfunction, regardless of the stage of their disease. |
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| ジャーナル名 | European journal of clinical investigation |
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| 投稿日 | 2024/9/28 |
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| 投稿者 | Ko, Toshiyuki; Kaneko, Hidehiro; Suzuki, Yuta; Okada, Akira; Azegami, Tatsuhiko; Fujiu, Katsuhito; Takeda, Norifumi; Morita, Hiroyuki; Yokoo, Takashi; Hayashi, Kaori; Komuro, Issei; Yasunaga, Hideo; Nangaku, Masaomi; Takeda, Norihiko |
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| 組織名 | Department of Cardiovascular Medicine, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Frontier Cardiovascular Science, Graduate School of Medicine, The;Department of Advanced Cardiology, University of Tokyo, Tokyo, Japan.;Center for Outcomes Research and Economic Evaluation for Health, National;Institute of Public Health, Saitama, Japan.;Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate;School of Medicine, The University of Tokyo, Tokyo, Japan.;Division of Endocrinology, Metabolism, and Nephrology, Department of Internal;Medicine, Keio University School of Medicine, Tokyo, Japan.;Division of Nephrology and Hypertension, Department of Internal Medicine, The;Jikei University School of Medicine, Tokyo, Japan.;International University of Health and Welfare, Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, University of Tokyo, Tokyo, Japan.;Division of Nephrology and Endocrinology, The University of Tokyo Graduate School;of Medicine, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/39334519/ |
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