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Is schizophrenia associated with an increased risk of chronic kidney disease? A nationwide matched-cohort study
  1. Nian-Sheng Tzeng1,2,
  2. Yung-Ho Hsu3,
  3. Shinn-Ying Ho4,5,
  4. Yu-Ching Kuo4,
  5. Hua-Chin Lee4,
  6. Yun-Ju Yin4,
  7. Hong-An Chen4,
  8. Wen-Liang Chen5,
  9. William Cheng-Chung Chu6,
  10. Hui-Ling Huang4,5
  1. 1Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
  2. 2Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
  3. 3Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
  4. 4Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan
  5. 5Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
  6. 6Department of Computer Science, Tunghai University, Taichung, Taiwan
  1. Correspondence to Dr Hui-Ling Huang; hlhuang{at}mail.nctu.edu.tw

Abstract

Objective The impact of schizophrenia on vital diseases, such as chronic kidney disease (CKD), has not as yet been verified. This study aims to establish whether there is an association between schizophrenia and CKD.

Design A nationwide matched cohort study.

Setting Taiwan's National Health Insurance Research Database.

Participants A total of 2338 patients with schizophrenia, and 7014 controls without schizophrenia (1:3), matched cohort for sex, age group, geography, urbanisation and monthly income, between 1 January 2003 and 31 December 2007, based on the International Classifications of Disease Ninth Edition (ICD-9), Clinical Modification codes.

Primary and secondary outcome measures After making adjustments for confounding risk factors, a Cox proportional hazards model was used to compare the risk of developing CKD during a 3-year follow-up period from the index date.

Results Of the 2338-subject case cohort, 163 (6.97%) developed a CKD, as did 365 (5.20%) of the 7014 control participants. Cox proportional hazards regression analysis revealed that patients with schizophrenia were more likely to develop CKD (HR=1.36, 95% CI 1.13 to 1.63; p<0.001). After adjusting for gender, age group, hypertension, diabetes mellitus, hyperlipidaemia, heart disease and non-steroid anti-inflammatory drugs (NSAIDs) usage, the HR for patients with schizophrenia was 1.25 (95% CI 1.04 to 1.50; p<0.05). Neither typical nor atypical antipsychotics was associated an increased risk of CKD in patients with schizophrenia.

Conclusions The findings from this population-based retrospective cohort study suggest that schizophrenia is associated with a 25% increase in the risk of developing CKD within only a 3-year follow-up period.

Keywords
  • Schizophrenia
  • chronic kidney diseases
  • National Health Insurance Research Dataset
  • non-steroid anti-inflammatory drugs

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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