Randomized, Placebo-controlled, Antidepressant Treatment of Patients with Major Depressive Disorder: Changes in Glomerular Filtration Rate

Abstract

Background

A bidirectional relationship between depression and renal dysfunction has been posited, however, a paucity of longitudinal data exists in individuals with major depression disorder (MDD). As depression may contribute to the progression of chronic kidney disease (CKD), we sought to determine whether effective depression treatment was associated with improvement in renal function.

Methods

A retrospective analysis performed on 1600 outpatients who underwent double-blind, placebo-controlled, randomized antidepressant treatment (DBPCRAT) of MDD in thirteen Eli Lilly and Company clinical trials. Magnitude of depression symptoms was measured with the Hamilton Depression Rating scale (HAMD); glomerular filtration rate (eGFR) was estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.

Results

After 7 weeks of DBPCRAT, HAMD scores in the treatment group decreased by 11.8 points, compared to 9.3 points in the placebo group (p < 0.0001). In the antidepressant-treated group, eGFR decreased by 0.28 ml/min/1.73 m² and by 0.88 ml/min/1.73 m² in the placebo-treated group (p = 0.17). Predictors of HAMD score at week 7 were baseline HAMD score (B = 0.237; p < 0.001), and antidepressant treatment (B = −2.28, p < 0.001). Predictors of eGFR were baseline eGFR (B = 0.651, p < 0.0001), increasing age (B = −0.194, p < 0.0001), and female gender (B = −0.984, p = 0.013).

Conclusion

Short-term, MDD was not associated with clinically significant decrements in eGFR. Future studies will determine whether depression treatment over a more prolonged period of time is associated with improvement in eGFR, especially in minorities and other high-risk populations.