Treatment of major depressive disorder (MDD) with sertraline did not change platelet function in patients with comorbid chronic kidney disease (CKD), according to study results published in BMC Nephrology. Further, there is no correlation between depressive symptoms and platelet function.
Nearly 25% of patients with CKD have MDD, and both conditions are independent risk factors for cardiovascular events. Information on the effects of selective serotonin reuptake inhibitors on platelet function in comorbid patients is limited.
Researchers analyzed changes in whole blood platelet aggregation and plasma endothelial activation marker levels in 175 patients with CKD and MDD who were randomly prescribed sertraline or placebo for 12 weeks. In order to determine whether differences in platelet function were related to CKD or MDD, researchers compared a subgroup of 49 comorbid patients with 43 patients with CKD but without MDD and 15 patients without CKD or MDD.
There were no significant correlations between severity of depressive symptoms and platelet function, and no significant changes in platelet function after 12 weeks of treatment with sertraline vs placebo in patients with MDD and CKD. Whole blood platelet aggregation was lower in the subgroup with no disorder or disease compared with the comorbid MDD/CKD subgroup and the subgroup with CKD and no MDD.
The study did not include a positive control group with MDD but without CKD, which might have more fully determined whether there was any MDD effect on platelet reactivity independent of CKD.
“First, we report no correlation between severity of depressive symptoms … and platelet function in patients with CKD and MDD. Second, we did not observe a sertraline effect on plasma markers of platelet activation or platelet aggregation after 12 weeks of treatment in CKD patients with depression,” researchers wrote. “These findings suggest that increased platelet activation may not be the major contributory underlying mechanism by which depression may lead to worse cardiovascular outcomes in patients with CKD.”
Jain N, Wan F, Kothari M, Adelodun A, Ware J, Sarode R, Hedayati SS. Association of platelet function with depression and its treatment with sertraline in patients with chronic kidney disease: analysis of a randomized trial. BMC Nephrol. 2019;20(1):395.