Dataset Information

Depression and the Effect of Sertraline on Inflammatory Biomarkers in Patients with Nondialysis CKD.

ABSTRACT:

Background

Inflammatory biomarkers are elevated in patients with CKD and associated with poor outcomes. Major depressive disorder (MDD) is prevalent in CKD and associated with inflammation. No studies investigated the effect of MDD treatment on plasma inflammatory biomarkers in patients with nondialysis CKD.

Methods

In a prespecified analysis of the randomized, double-blind CKD Antidepressant Sertraline Trial, we investigated whether treatment with sertraline versus placebo or response to treatment would affect plasma levels of albumin, prealbumin, IL-6, and high-sensitivity C-reactive protein (hsCRP), measured at baseline and after 12 weeks of treatment. We also explored whether somatic versus nonsomatic depressive symptoms, measured using the Quick Inventory of Depressive Symptomatology, and quality-of-life subscales, measured using the Kidney Disease Quality of Life Short Form, were associated with baseline levels of these inflammatory biomarkers.

Results

Of the 193 participants, mean age was 58.4 (SD 13) years and 58% were black, 42% were white, and 18% were Hispanic. Higher baseline hsCRP correlated with somatic depressive symptoms (r=0.21; P=0.01), fatigue (r=0.22; P=0.005), and poorer physical functioning (r=-0.26; P=0.001). There was no change in hsCRP in the sertraline group. hsCRP increased in placebo nonresponders from baseline (median, 3.7 mg/L; interquartile range [IQR], 1.7-10.0 mg/L) to exit (median, 4.9 mg/L; IQR, 1.8-8.8 mg/L; P=0.01). The change from baseline to exit differed between placebo responders (median, -0.4 mg/L; IQR, -9.3 to 0.2 mg/L) and nonresponders (median, 0.8 mg/L; IQR, -0.1 to 3.9 mg/L; P=0.008). There were no differences in changes in albumin, prealbumin, or IL-6 from baseline in any group.

Conclusions

Among patients with CKD and MDD, hsCRP correlated with somatic symptoms of depression and fatigue, but not with nonsomatic symptoms. Sertraline treatment was not associated with a longitudinal change in hsCRP from baseline regardless of treatment effect on depressive symptoms, but those who failed to respond to placebo had an increase in hsCRP over time. This area deserves further investigation.

Clinical trial registry name and registration number

CKD Antidepressant Sertraline Trial (CAST), NCT00946998.

SUBMITTER: Gregg LP

PROVIDER: S-EPMC8809306 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Depression and the Effect of Sertraline on Inflammatory Biomarkers in Patients with Nondialysis CKD.

Gregg L Parker LP Carmody Thomas T Le Dustin D Bharadwaj Nina N Trivedi Madhukar H MH Hedayati S Susan SS

Kidney360 20200413 6

<h4>Background</h4>Inflammatory biomarkers are elevated in patients with CKD and associated with poor outcomes. Major depressive disorder (MDD) is prevalent in CKD and associated with inflammation. No studies investigated the effect of MDD treatment on plasma inflammatory biomarkers in patients with nondialysis CKD.<h4>Methods</h4>In a prespecified analysis of the randomized, double-blind CKD Antidepressant Sertraline Trial, we investigated whether treatment with sertraline versus placebo or res ...[more]

PMID: 35368605

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Dataset Information

Depression and the Effect of Sertraline on Inflammatory Biomarkers in Patients with Nondialysis CKD.

Background

Methods

Results

Conclusions

Clinical trial registry name and registration number

Publications

Depression and the Effect of Sertraline on Inflammatory Biomarkers in Patients with Nondialysis CKD.

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