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In the present study, we analysed a nationwide epidemiological dataset to investigate the dose\u2010dependent association between baseline eGFR and a future risk of developing depression in a general population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analysed 1,518,885 individuals (male: 46.3%) without a history of depression identified between April 2014 and November 2022 within a nationwide epidemiological database, provided by DeSC Healthcare (Tokyo, Japan). We investigated the association of eGFR with the incidence of depression using Cox regression analyses and also conducted cubic spline analysis to investigate the dose\u2010dependent association between eGFR and depression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the mean follow\u2010up of 1218\u2009\u00b1\u2009693\u2009days, 45,878 cases (3.0% for total participants, 2.6% for men and 3.3% for women) of depression were recorded. The risk of depression increased with the eGFR decline as well as the presence of proteinuria. Multivariable Cox regression analysis showed the hazard ratio (95% CI) of depression in each kidney function category (eGFR \u226590, 60\u201389, 45\u201359, 30\u201344, 15\u201329, and\u2009&lt;\u200915\u2009mL\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>) was 1.14 (1.11\u20131.17), 1 (reference), 1.11 (1.08\u20131.14), 1.51 (1.43\u20131.59), 1.77 (1.57\u20131.99) and 1.77 (1.26\u20132.50), respectively. In the cubic spline analysis, the risk of depression continued to increase monotonically as the eGFR declined when the eGFR fell below approximately 65\u2009mL\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our analysis using a large\u2010scale epidemiological dataset presented the dose\u2010dependent association between eGFR decline and the risk of depression, which highlights the importance of incorporating mental health assessments into the routine care of patients with kidney dysfunction, regardless of the stage of their disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.14322","type":"journal-article","created":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T03:47:59Z","timestamp":1727495279000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Dose\u2010dependent association between estimated glomerular filtration rate and the subsequent risk of depression: An analysis of a nationwide epidemiological dataset"],"prefix":"10.1111","volume":"55","author":[{"given":"Toshiyuki","family":"Ko","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Department of Frontier Cardiovascular Science, Graduate School of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2553-6170","authenticated-orcid":false,"given":"Hidehiro","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine The University of Tokyo  Tokyo Japan"},{"name":"Department of Advanced Cardiology University of Tokyo  Tokyo 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