Department of Occupational, Metabolic and Internal Diseases, Medical University of Gdańsk, 81-519 Gdynia, Poland.
Department of Developmental Psychiatry, Psychotic and Geriatric Disorders, Medical University of Gdansk, 80-282 Gdańsk, Poland.
Medicina (Kaunas). 2021 Sep 9;57(9):949. doi: 10.3390/medicina57090949.
Depression and anxiety are the most common psychiatric disorders in end-stage renal disease (ESRD) patients treated with hemodialysis (HD) and may correlate with lower quality of life and increased mortality. Depression treatment in HD patients is still a challenge both for nephrologists and psychiatrists. The possible treatment of depressive disorders can be pharmacological and non-pharmacological. In our article, we focus on the use of sertraline, the medication which seems to be relatively safe and efficient in the abovementioned population, taking under consideration several limitations regarding the use of other selective serotonin reuptake inhibitors (SSRIs). In our paper, we discuss different aspects of sertraline use, taking into consideration possible benefits and side effects of drug administration like impact on QTc (corrected QT interval) prolongation, intradialytic hypotension (IDH), chronic kidney disease-associated pruritus (CKD-aP), bleeding, sexual functions, inflammation, or fracture risk. Before administering the medication, one should consider benefits and possible side effects, which are particularly significant in the treatment of ESRD patients; this could help to optimize clinical outcomes. Sertraline seems to be safe in the HD population when provided in proper doses. However, we still need more studies in this field since the ones performed so far were usually based on small samples and lacked placebo control.
抑郁和焦虑是接受血液透析 (HD) 治疗的终末期肾病 (ESRD) 患者中最常见的精神疾病，可能与生活质量降低和死亡率增加有关。HD 患者的抑郁治疗仍然是肾病学家和精神科医生面临的挑战。抑郁障碍的可能治疗方法包括药物治疗和非药物治疗。在我们的文章中，我们专注于使用舍曲林，考虑到使用其他选择性 5-羟色胺再摄取抑制剂 (SSRIs) 的一些限制，这种药物在上述人群中似乎相对安全且有效。在本文中，我们讨论了舍曲林使用的不同方面，考虑了药物管理的可能益处和副作用，如对 QTc（校正 QT 间期）延长、透析中低血压 (IDH)、慢性肾脏病相关瘙痒 (CKD-aP)、出血、性功能、炎症或骨折风险的影响。在给药之前，应考虑益处和可能的副作用，这在 ESRD 患者的治疗中尤为重要；这有助于优化临床结果。舍曲林在 HD 人群中似乎是安全的，只要给予适当的剂量。然而，我们仍然需要在这一领域进行更多的研究，因为迄今为止进行的研究通常基于小样本且缺乏安慰剂对照。
