Journal Article Annotations
2017, 2nd Quarter
Annotations by Paula Zimbrean, MD, FAPM and Marta Novak, MD, PHD
The finding: Patients with end-stage kidney disease who were not white had less access to the kidney transplantation compared to white Canadians. This access was primarily driven by differences in availability of living donor.
Strength and weaknesses: This was a retrospective study of over 2000 patients who were evaluated at Toronto General Hospital over a 10-year period. The strengths of the study come from the long duration of follow-up, a high number of patients, and the standardized evaluation and data collection. The limitations are due to its retrospective character and to the fact that it was based on one single center, which questions its generalizability.
Relevance: This study underlines the differences in access to kidney transplantation between white and non-white populations. It supports the need for further study to evaluate what are no barriers to care and what interventions could be implemented to address this health disparity.
The finding: This study shows that patients with chronic kidney disease are more likely to be prescribed antidepressant medications compared to the general population. Selective serotonin reuptake inhibitors were the most common antidepressant prescribed.
Strength and weaknesses: This is an analysis of over 200,000 patients with and without chronic kidney disease treated over a 10 -year period, based on the UK Clinical Practice Research Datalink (CPRD). CPRD is a governmental, not-for-profit research service, jointly funded by the NHS National Institute for Health Research (NIHR) and the Medicines and Healthcare products Regulatory Agency (MHRA), a part of the UK Department of Health. It provides anonymized primary care records for public health research.
Relevance: This is likely the biggest study today looking at the use of antidepressants in chronic kidney disease. It was interesting to note that antidepressants are widely prescribed, despite the lack of studies informing of their efficacy and safety in this population. This study supports the need for additional research regarding the use of antidepressants in patients with chronic kidney disease.