@article{da4aa0999a8949b9800a1982f081ee06,
title = "Antidepressant medication use before and after kidney transplant: implications for outcomes – a retrospective study",
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.",
keywords = "antidepressants, kidney transplantation, mortality, pharmacy records, registries",
author = "Lentine, {Krista L.} and Naik, {Abhijit S.} and Rosemary Ouseph and Zidong Zhang and Axelrod, {David A.} and Segev, {Dorry L.} and Dharnidharka, {Vikas R.} and Brennan, {Daniel C.} and Henry Randall and Raj Gadi and Lam, {Ngan N.} and Hess, {Gregory P.} and Kasiske, {Bertram L.} and Schnitzler, {Mark A.}",
note = "Funding Information: KLL, DA, DLS, VRD and DCB receive support from a grant from the National Institutes of Health (NIH)/ National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) R01-R01DK102981. Funding Information: KLL, DA, DLS, VRD and DCB receive support from a grant from the National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) R01- R01DK102981. This work was conducted under the auspices of the Minneapolis Medical Research Foundation, contractor for the Scientific Registry of Transplant Recipients (SRTR), as a deliverable under contract no. HHSH250201000018C (US Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation). As a US Government-sponsored work, there are no restrictions on its use. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the US Government. KLL, DA, DLS, VRD and DCB receive support from a grant from the National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) R01-R01DK102981. NNL is supported by a KRESCENT New Investigator Award. The opinions, results, and conclusions reported in this article are those of the authors and are independent of the funding sources. The authors thank SRTR colleague Nan Booth, MSW, MPH, ELS, for manuscript editing. An abstract describing this work was accepted for oral presentation at the American Transplant Congress, May 2017, Chicago, IL. Funding Information: This work was conducted under the auspices of the Minneapolis Medical Research Foundation, contractor for the Scientific Registry of Transplant Recipients (SRTR), as a deliverable under contract no. HHSH250201000018C (US Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation). As a US Government-sponsored work, there are no restrictions on its use. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy of or interpretation by the SRTR or the US Government. KLL, DA, DLS, VRD and DCB receive support from a grant from the National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) R01-R01DK102981. NNL is supported by a KRES-CENT New Investigator Award. The opinions, results, and conclusions reported in this article are those of the authors and are independent of the funding sources. The authors thank SRTR colleague Nan Booth, MSW, MPH, ELS, for manuscript editing. An abstract describing this work was accepted for oral presentation at the American Transplant Congress, May 2017, Chicago, IL. Publisher Copyright: {\textcopyright} 2017 Steunstichting ESOT",
year = "2018",
month = jan,
doi = "10.1111/tri.13006",
language = "English (US)",
volume = "31",
pages = "20--31",
journal = "Transplant International",
issn = "0934-0874",
publisher = "Frontiers Media SA",
number = "1",
}