Table 3.
Clinical trials of change in inflammatory biomarker levels with treatment of depression in patients with ESKD
| Study | Sample | Intervention | Depression definition | Timing | Albumin levela (g/dl) | CRP levela (mg/dl) | hsCRP levela (mg/dl) | IL-6 levela (pg/ml) | TNF-α levela (pg/ml) | IL-1 levela (pg/ml) |
|---|---|---|---|---|---|---|---|---|---|---|
| Lee et al.65 | 28 HD | Fluoxetine 20 mg/d (8 wk) | BDI ≥11 and HAMD ≥7 | Baseline | 219 ± 50b | 7.26 ± 2.51 | 80.67 ± 11.4 | 18.87 ± 2.1 | ||
| Study exit | 234 ± 60b | 10.58 ± 2.37c | 65.37 ± 5.97 | 10.52 ± 1.18c | ||||||
| Cilan et al.42 | 9 HD | Sertraline 50 mg/d (8 wk) | DSM IV criteria | Baseline | 143.78 ± 85.84 | 109.22 ± 260.15 | 135.89 ± 171.46 | |||
| Study exit | 54.63 ± 83.71 | 56.56 ± 162.61 | 127.11 ± 216.27 | |||||||
| Cilan et al.46 | 10 PD | Sertraline 50 mg/d (8 wk) | DSM IV criteria | Baseline | 3.40 ± 0.60 | 9.01 (3.17–57.9) | 46.5 (5–200) | 25.5 (1–800) | 25 (3–340) | |
| Study exit | 3.21 ± 0.44 | 6.48 (3.17–41.4) | 200 (160–200)c | 220 (1–800) | 375 (3–500)c | |||||
| Taraz et al.66 | 50 HD (n = 21 in the sertraline group) | Sertraline 100 mg/d vs. placebo (12 wk) | BDI ≥16 | Baseline | 4.3 ± 0.3 | 4.0 (IQR, 2.8) | 7.8 (IQR, 6.6) | 13 (IQR, 8.9) | ||
| Study exit | 4.4 ± 0.3 | 3.9 (IQR, 3.0) | 4.7 (IQR, 4.9)c | 8.5 (IQR, 6)c | ||||||
| Zahed et al.67 | 35 HD with CRP level >5 mg/dl | Sertraline 50–200 mg/d (12 wk) | BDI >14 | Baseline | 3.09 ± 0.86 | 33.5 ± 24.2 | ||||
| Study exit | 4.17 ± 0.57 | 15.4 ± 12.6c | ||||||||
| Zhao et al.63 | 189 HD (n = 63 in the escitalopram group) | Escitalopram 20 mg/d and/or exercise (18 wk) | BDI ≥14 | Values not reported; P > 0.05 for comparison of baseline to study exit |
BDI, Beck Depression Index; CRP, C-reactive protein; DSM IV, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; ESKD, end-stage kidney disease; HAMD, Hamilton Depression Scale; HD, hemodialysis; hsCRP, high-sensitivity C-reactive protein; IL, interleukin; IQR, interquartile range; PD, peritoneal dialysis; TNF-α, tumor necrosis factor-α.
Presented as mean ± SD or median (IQR) at baseline (before antidepressant treatment) and at study exit.
Reported as 2.19 ± 0.5 mg/ml at baseline and 2.34 ± 0.6 mg/ml at study exit. Values have been converted to mg/dl for consistency in this table.
P < 0.05 compared to the baseline value.