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Whether early-stage CKD is a risk factor for suicide warrants further research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This nationwide, retrospective, cohort study aimed to evaluate the risk of suicide in patients with early-stage CKD and identify the associated risk factors. A total of 3.945,198 individuals aged\u2009\u2265\u200919\u00a0years who underwent the 2009 national health screening in South Korea were studied. Among them, 202,291 patients had early-stage CKD (estimated glomerular filtration rate (eGFR)\u2009\u2265\u200930 and\u2009&lt;\u200960\u00a0mL\/min per 1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      and\/or dipstick albuminuria\u2009\u2265\u20091\u2009+). The study outcome was suicide as confirmed by the nationwide death register based on death certificates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study population had a mean age of 59\u2009\u00b1\u200915\u00a0years, and 47% were male. We identified 930 suicides (incidence rate, 0.45 per 1000 person-years) in the CKD group and 11,332 suicides (incidence rate, 0.27 per 1000 person-years) in the non-CKD group. Early-stage CKD was significantly associated with an increased risk of suicide in multivariable analysis adjusted for demographic characteristics; lifestyle habits; comorbidities, including diabetes and hypertension; economic status; and depression, bipolar disorder, schizophrenia (hazard ratio, 1.18; 95% confidence interval 1.10\u20121.26). Suicide incidence was higher in individuals with proteinuria but preserved kidney function (eGFR\u2009&gt;\u200960\u00a0mL\/min per 1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      and dipstick albuminuria\u2009&gt;\u20091\u2009+) than in those without CKD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Healthcare providers may need to examine the mental health of patients with early-stage CKD to prevent suicide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-025-02219-3","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T09:24:32Z","timestamp":1744190672000},"page":"989-998","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Early-stage chronic kidney disease as a risk factor for suicide: a nationwide observational cohort study"],"prefix":"10.1093","volume":"38","author":[{"given":"Hyuk","family":"Huh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungdo","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minsang","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Sun","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeo Jin","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sehyun","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Min","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong Geun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semin","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soojin","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunjeong","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaerim","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong Ki","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sehoon","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"issue":"6","key":"2219_CR1","doi-asserted-by":"publisher","first-page":"2837","DOI":"10.1111\/j.1523-1755.2005.00757.x","volume":"68","author":"J Chen","year":"2005","unstructured":"Chen J, Wildman RP, Gu D, Kusek JW, Spruill M, Reynolds K, Liu D, Hamm LL, Whelton PK, He J (2005) Prevalence of decreased kidney function in Chinese adults aged 35 to 74 years. 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All the authors declare no relevant financial or non-financial interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study protocol was reviewed and approved by the Institutional Review Board of the Seoul National University Hospital (IRB No. 2112\u2013048-1281). The utilization of the National Health Insurance Service (NHIS) database was approved by the relevant government organizations (NHIS-2022\u20131-543).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The research adhered to the ethical principles outlined in the 1964 Helsinki Declaration, including its subsequent amendments or equivalent ethical guidelines. It also complied with both national and local ethical standards.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}},{"value":"The requirement for informed consent was waived because data analyses were performed retrospectively using anonymized information. This study was conducted in accordance with the principles of the Declaration of Helsinki.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}