Journal article
Antidepressant medication use before and after kidney transplant: implications for outcomes - a retrospective study
Transplant international, Vol.31(1), pp.20-31
01/01/2018
DOI: 10.1111/tri.13006
PMCID: PMC6334638
PMID: 28771882
Abstract
We examined a novel database wherein national US transplant registry identifiers were linked to records from a large pharmaceutical claims warehouse (2008-2015) to characterize antidepressant use before and after kidney transplantation, and associations [adjusted hazard ratio (aHR) 95% CI] with death and graft failure. Among 72 054 recipients, 12.6% filled antidepressant medications in the year before transplant, and use was more common among women and patients who were white, unemployed, and had limited functional status. Pre-transplant antidepressant use was associated with 39% higher 1-year mortality (aHR 1.39, 95% CI 1.18-1.64) and 15% higher all-cause graft loss risk (aHR 1.15, 95% CI 1.02-1.30). More than 50% of patients who filled antidepressants pre-transplant continued fill post-transplant. Antidepressant use in the first year after transplant was associated with twofold higher risk of death (aHR 1.94, 95% CI 1.60-2.35), 38% higher risk of death-censored graft failure, and 61% higher risk of all-cause graft failure in the subsequent year. Pre-listing antidepressant use was also associated with increased mortality, but transplantation conferred a survival benefit regardless of prelisting antidepressant use status. While associations may in part reflect underlying behaviors or comorbidities, kidney transplant candidates and recipients treated with antidepressant medications should be monitored and supported to reduce the risk of adverse outcomes.
Details
- Title: Subtitle
- Antidepressant medication use before and after kidney transplant: implications for outcomes - a retrospective study
- Creators
- Krista L. Lentine - Saint Louis UniversityAbhijit S. Naik - University of MichiganRosemary Ouseph - Saint Louis UniversityZidong Zhang - Saint Louis UniversityDavid A. Axelrod - Lahey Hospital and Medical CenterDorry L. Segev - Saint Louis UniversityVikas R. Dharnidharka - Washington University in St. LouisDaniel C. Brennan - Washington University in St. LouisHenry Randall - Saint Louis UniversityRaj Gadi - Saint Louis UniversityNgan N. Lam - University of AlbertaGregory P. Hess - Leonard Davis Institute of Health EconomicsBertram L. Kasiske - Hennepin County Medical CenterMark A. Schnitzler - Saint Louis University
- Resource Type
- Journal article
- Publication Details
- Transplant international, Vol.31(1), pp.20-31
- DOI
- 10.1111/tri.13006
- PMID
- 28771882
- PMCID
- PMC6334638
- NLM abbreviation
- Transpl Int
- ISSN
- 0934-0874
- eISSN
- 1432-2277
- Publisher
- Wiley
- Number of pages
- 12
- Grant note
- R01DK102981 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) R01-R01DK102981 / National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
- Language
- English
- Date published
- 01/01/2018
- Academic Unit
- Surgery
- Record Identifier
- 9984322797202771
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