Risk of major depression in patients with chronic renal failure on different treatment modalities: A matched‐cohort and population‐based study in T aiwan

The influence of different treatment modalities on the risk of developing major depression in patients with chronic renal failure ( CRF ) is not well understood. We aimed to explore the incidence of major depression among patients with CRF who were on different dialysis modalities, who had received renal transplantation ( RT ), and those who had not yet received any of the aforementioned renal replacement therapies. We conducted a population‐based retrospective cohort study using a national health insurance research database. This study investigated 89,336 study controls, 17,889 patients with chronic kidney disease on conservative treatment, 3823 patients on hemodialysis ( HD ), 351 patients on peritoneal dialysis ( PD ), and 322 patients who had RT . We followed all individuals until the occurrence of major depression or the date of loss to follow‐up. The PD group had the highest risk (hazard ratio [ HR ] 2.43; 95% confidence interval [ CI ] 1.26–4.69), whereas the RT group had the lowest risk ( HR 0.18; 95% CI 0.03–1.29) of developing major depression compared with the control group. Patients initiated on PD had a higher risk of developing major depression than patients initiated on HD (pairwise comparison: HR 2.20; 95% CI 1.09–4.46). Different treatment modalities are associated with different risks of developing major depression in patients with CRF . Among renal replacement therapies, patients who have had RT have the lowest risk of developing major depression. Patients who initiate renal therapy on PD may have a higher risk of major depression compared with patients who initiate renal therapy on HD .