Major depression complicating hemodialysis in patients with chronic renal failure: A multicenter, double-blind, controlled clinical trial of S-adenosyl-L-methionine versus placebo

Ancarani, E; Biondi, Brunello; Bolletta, A; Cestra, D.; Bella, E. De; Nirchi, M.A.; Nucera, Gabriella; Orlandi, Neraldo; Persichetti, S; Scaccia, F.; Sonsini, U.; Taccone-Gallucci, M

doi:10.1016/s0011-393x(05)80698-8

Cited by 10 publications

(5 citation statements)

References 18 publications

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“…performances of available screening tools for depression has not been done, trials of screening showing efficacy and cost effectiveness in this population are not available, and randomized trials of interventions are limited by small sample size, short duration, and reliance on surrogate outcomes (depression scores). [15][16][17][18][19][20] appropriate as altered drug clearances and frequent cardiovascular comorbidity may alter the relative risks and benefits from treatment in people with CKD. The strengths of this review are the comprehensive search for individual studies, the standardized methodology conducted by two independent reviewers, and the relevance of the findings to clinical practice and research strategy.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 Randomized trials of treatment and screening for depression in CKD are sparse and limited by small sample sizes and surrogate outcomes. [15][16][17][18][19][20] Summarizing the prevalence of depression in people with CKD is therefore an important first step in understanding the burden of illness in this population and developing additional research priorities. We conducted a systematic review and meta-analysis of studies of depression in adults with CKD to explore the prevalence of depressive symptoms and the effects of diagnostic methods and CKD severity on prevalence estimates.…”

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confidence: 99%

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Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies

Palmer

Vecchio

Craig

et al. 2013

Kidney International

684

495

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Prevalence estimates of depression in chronic kidney disease (CKD) vary widely in existing studies. We conducted a systematic review and meta-analysis of observational studies to summarize the point prevalence of depressive symptoms in adults with CKD. We searched MEDLINE and Embase (through January 2012). Random-effects meta-analysis was used to estimate the prevalence of depressive symptoms. We also limited the analyses to studies using clinical interview and prespecified criteria for diagnosis. We included 249 populations (55,982 participants). Estimated prevalence of depression varied by stage of CKD and the tools used for diagnosis. Prevalence of interview-based depression in CKD stage 5D was 22.8% (confidence interval (CI), 18.6-27.6), but estimates were somewhat less precise for CKD stages 1-5 (21.4% (CI, 11.1-37.2)) and for kidney transplant recipients (25.7% (12.8-44.9)). Using self- or clinician-administered rating scales, the prevalence of depressive symptoms for CKD stage 5D was higher (39.3% (CI, 36.8-42.0)) relative to CKD stages 1-5 (26.5% (CI, 18.5-36.5)) and transplant recipients (26.6% (CI, 20.9-33.1)) and suggested that self-report scales may overestimate the presence of depression, particularly in the dialysis setting. Thus, interview-defined depression affects approximately one-quarter of adults with CKD. Given the potential prevalence of depression in the setting of CKD, randomized trials to evaluate effects of interventions for depression on patient-centered outcomes are needed.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies

Palmer

Vecchio

Craig

et al. 2013

Kidney International

684

495

View full text Add to dashboard Cite

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“…Despite the high prevalence of depression and its association with poor outcomes, only a minority of patients with ESKD are given a diagnosis of, or receive treatment for, depression (Hedayati and Finkelstein, 2009). This may in part be due to the limited systematic study in this area, with only six small randomised controlled trials (RCTs) available to guide treatment safety and efficacy (Ancarani, 1993;Baines et al, 2004;Blumenfield et al, 1997;Duarte et al, 2009;Koo et al, 2005;Lii et al, 2007). The following section reviews what pharmacological and non-pharmacological approaches are available for the management of depression in CKD.…”

Section: Managementmentioning

confidence: 99%

“…A statistically significant improvement in depression was found after 4 weeks amongst those given fluoxetine; however, this was not sustained at 8 weeks. Non-randomised, observational studies (Ancarani, 1993;Baines et al, 2004;Blumenfield et al, 1997;Duarte et al, 2009;Koo et al, 2005;Lii et al, 2007) suggest that antidepressant medication may be useful in CKD; however, further studies are needed.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Depression and chronic kidney disease: A review for clinicians

Bautovich

Katz

Smith

et al. 2014

Aust N Z J Psychiatry

119

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“…Moderate kidney disease (estimated glomerular filtration rate below 44 ml/min per 1.73 m 2 and/or heavy proteinuria) is associated with a 2- to 3- fold increase in all-cause mortality compared with the general population and for dialysis patients the risk is much higher [7,8]. Despite poorer clinical outcomes, pharmacologic and dialysis-related interventions (including anti-platelet agents, [9] dialysis dose, [10] early dialysis initiation, [11] vitamin D compounds, [12] erythropoietins [13], phosphodiesterase-5 inhibitors, [14] or antidepressant medication [15-20]) generally do not improve clinical outcomes or quality of life, particularly for those with end-stage kidney disease treated with dialysis. Exploration of additional and modifiable determinants of health in populations with chronic kidney disease would help prioritize the evaluation of novel intervention strategies to improve clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Oral disease in adults treated with hemodialysis: prevalence, predictors, and association with mortality and adverse cardiovascular events: the rationale and design of the ORAL Diseases in hemodialysis (ORAL-D) study, a prospective, multinational, longitudinal, observational, cohort study

Strippoli

Palmer

Ruospo³

et al. 2013

BMC Nephrol

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BackgroundPeople with end-stage kidney disease treated with dialysis experience high rates of premature death that are at least 30-fold that of the general population, and have markedly impaired quality of life. Despite this, interventions that lower risk factors for mortality (including antiplatelet agents, epoetins, lipid lowering, vitamin D compounds, or dialysis dose) have not been shown to improve clinical outcomes for this population. Although mortality outcomes may be improving overall, additional modifiable determinants of health in people treated with dialysis need to be identified and evaluated.Oral disease is highly prevalent in the general population and represents a potential and preventable cause of poor health in dialysis patients. Oral disease may be increased in patients treated with dialysis due to their lower uptake of public dental services, as well as increased malnutrition and inflammation, although available exploratory data are limited by small sample sizes and few studies evaluating links between oral health and clinical outcomes for this group, including mortality and cardiovascular disease. Recent data suggest periodontitis may be associated with mortality in dialysis patients and well-designed, larger studies are now required.Methods/designThe ORAL Diseases in hemodialysis (ORAL-D) study is a multinational, prospective (minimum follow-up 12 months) study. Participants comprise consecutive adults treated with long-term in-center hemodialysis. Between July 2010 and February 2012, we recruited 4500 dialysis patients from randomly selected outpatient dialysis clinics in Europe within a collaborative network of dialysis clinics administered by a dialysis provider, Diaverum, in Europe (France, Hungary, Italy, Poland, Portugal, and Spain) and South America (Argentina). At baseline, dental surgeons with training in periodontology systematically assessed the prevalence and characteristics of oral disease (dental, periodontal, mucosal, and salivary) in all participants. Oral hygiene habits and thirst were evaluated using self-administered questionnaires. Data for hospitalizations and mortality (total and cause-specific) according to baseline oral health status will be collected once a year until 2022.DiscussionThis large study will estimate the prevalence, characteristics and correlations of oral disease and clinical outcomes (mortality and hospitalization) in adults treated with dialysis. We will further evaluate any association between periodontitis and risk of premature death in dialysis patients that has been suggested by existing research. The results from this study should provide powerful new data to guide strategies for future interventional studies for preventative and curative oral disease strategies in adults who have end-stage kidney disease.

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Major depression complicating hemodialysis in patients with chronic renal failure: A multicenter, double-blind, controlled clinical trial of S-adenosyl-L-methionine versus placebo

Cited by 10 publications

References 18 publications

Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies

Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies

Depression and chronic kidney disease: A review for clinicians

Oral disease in adults treated with hemodialysis: prevalence, predictors, and association with mortality and adverse cardiovascular events: the rationale and design of the ORAL Diseases in hemodialysis (ORAL-D) study, a prospective, multinational, longitudinal, observational, cohort study

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