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Experimental studies suggest the role of urea toxicity in depression. We assessed both the incidence of antidepressant prescriptions and depressive symptoms (measured by CESD (Center for Epidemiologic Depression) scale) in 2505 patients with CKD (Stage 3\u20134) followed up over 5 years in the Chronic Kidney Disease Renal Epidemiology and Information Network (CKD-REIN) cohort. We used a joint model to assess the association between the serum urea level and incident antidepressant prescriptions, and mixed models for the association between the baseline serum urea level and CESD score over the 5-year follow-up. Among the 2505 patients, 2331 were not taking antidepressants at baseline. Of the latter, 87 started taking one during a median follow-up of 4.6 years. After adjustment for confounding factors, the hazard ratio for incident antidepressant prescription associated with the serum urea level (1.28 [95%CI, 0.94,1.73] per 5 mmol\/L increment) was not significant. After adjustment, the serum urea level was associated with the mean change in the CESD score (\u03b2 = 0.26, [95%CI, 0.11,0.41] per 5 mmol\/L increment). Depressive symptoms burden was associated with serum urea level unlike depression events. Further studies are needed to draw firm conclusions and better understand the mechanisms of depression in CKD.<\/jats:p>","DOI":"10.3390\/toxins16070326","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T12:20:38Z","timestamp":1721650838000},"page":"326","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Urea Level and Depression in Patients with Chronic Kidney Disease"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3666-1407","authenticated-orcid":false,"given":"H\u00e9l\u00e8ne","family":"Levassort","sequence":"first","affiliation":[{"name":"Geriatrics, H\u00f4pital Ambroise-Par\u00e9, Assistance Publique des H\u00f4pitaux de Paris (APHP), UVSQ, 9 Avenue Charles de Gaulle, F-92100 Boulogne-Billancourt, France"},{"name":"Centre for Research in Epidemiology and Population Health (CESP), Clinical Epidemiology Team, Inserm U1018, Paris-Saclay University, 12 Avenue Paul Vaillant Couturier, F-94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Boucquemont","sequence":"additional","affiliation":[{"name":"Centre for Research in Epidemiology and Population Health (CESP), Clinical Epidemiology Team, Inserm U1018, Paris-Saclay University, 12 Avenue Paul Vaillant Couturier, F-94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oriane","family":"Lambert","sequence":"additional","affiliation":[{"name":"Centre for Research in Epidemiology and Population Health (CESP), Clinical Epidemiology Team, Inserm U1018, Paris-Saclay University, 12 Avenue Paul Vaillant Couturier, F-94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5384-9006","authenticated-orcid":false,"given":"Sophie","family":"Liabeuf","sequence":"additional","affiliation":[{"name":"Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens-Picardie University Medical Center, F-80054 Amiens, France"},{"name":"MP3CV Laboratory, Jules Verne University of Picardie, F-80054 Amiens, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0214-5567","authenticated-orcid":false,"given":"Solene M.","family":"Laville","sequence":"additional","affiliation":[{"name":"Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens-Picardie University Medical Center, F-80054 Amiens, France"},{"name":"MP3CV Laboratory, Jules Verne University of Picardie, F-80054 Amiens, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Teillet","sequence":"additional","affiliation":[{"name":"Geriatrics, H\u00f4pital Ambroise-Par\u00e9, Assistance Publique des H\u00f4pitaux de Paris (APHP), UVSQ, 9 Avenue Charles de Gaulle, F-92100 Boulogne-Billancourt, France"},{"name":"Centre for Research in Epidemiology and 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