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논문분류	춘계학술대회 초록집
제목	Comparison of Bleeding Complications between Selective Serotonin Reuptake Inhibitors and Other Antidepressant Use among End-Stage Kidney Disease Patients
저자	Jun Young Lee
출판정보	2024; 2024(1):
키워드
초록	Objectives: The prevalence of major depressive disorder in end-stage kidney disease (ESKD) varies between 20% and 40% and is linked to increased mortality and lower quality of life. Selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed antidepressants for patients with ESKD but can increase bleeding, which is an important issue for this population. The comparison of SSRIs and other antidepressant among ESKD has rarely been investigated to date. Methods: This is a nationwide cohort study using data obtained from the Korean National Health Insurance Service Database. ESKD patients were first prescribed antidepressants after starting renal replacement therapy between January 2002 and December 2018. The primary outcome was all-cause mortality. The secondary outcomes were the occurrence of hospitalization for major bleeding, including GI bleeding and intracranial hemorrhage. Results: During the mean follow-up of 2.5 years, SSRI users had a lower risk of all-cause death (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.75–0.84) and hospitalization for major bleeding (HR 0.89, 95% CI 0.84–0.95) but no increased risk of bleeding death (HR 0.85, 95% CI 0.66–1.09) compared with non-SSRI users. The protective effects of SSRI use for all-cause death and hospitalization for major bleeding were consistent in those prescribed SSRIs for <120 days (death: HR 0.81, 95% CI 0.75–0.86; major bleeding: HR 0.84, 95% CI 0.78–0.91) and those concomitantly using bleeding-related drugs (death: HR 0.86, 95% CI 0.79–0.94; major bleeding: HR 0.88, 95% CI 0.80–0.96) and more prominent among strong SSRI users (death: HR 0.7, 95% CI 0.62–0.79; major bleeding: HR 0.76, 95% CI 0.65–0.87). Conclusions: In patients with ESKD and depression, SSRI use was associated with reduced all-cause death and hospitalization for major bleeding compared with non-SSRI antidepressant use.
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