# Mechanisms for Behavior Change and Maintenance of Treatment for CKD Comorbid Depression

> **NIH NIH R01** · UT SOUTHWESTERN MEDICAL CENTER · 2022 · $426,044

## Abstract

Project Summary/Abstract
The purpose of this application is to understand why interventions for the treatment of Major Depressive
Disorder (MDD) work or do not work initially and over time in patients with Chronic Kidney Disease (CKD). This
project will add assessments to my ongoing NIH R01-funded study (R01DK124379-05), Combination of Novel
Therapies for CKD Comorbid Depression, to help illuminate mechanisms of action mediating response to
treatment; facilitators and barriers to adoption of treatment; and maintenance of treatment response. We will
collect complimentary data that will use information from the subset of participants who have completed the
parent study to investigate mechanisms for depression treatment effect, or lack thereof, and also identify the
maintenance of treatment effect beyond the active intervention period in those who initially have remission in
depression after 8 weeks of treatment. In the parent R01 study, we are currently comparing the efficacy of two
16-week strategies vs. control for treatment of MDD starting with (1) Behavioral Activation Therapy (BAT) or (2)
bupropion drug therapy, each augmented to a combination of both in non-remitters after 8 weeks. We will
engage the subset of participants that have completed the parent trial to: Aim 1. Identify mechanisms
of action of intervention effect, vs. lack thereof, by identifying candidate inflammatory
mediators/moderators of MDD treatment response in CKD patients. We will use (a) RNA-Sequencing of whole
blood gene expression and (b) plasma inflammatory biomarkers from frozen samples that have already been
collected at baseline and at week 8 from patients who completed at least 8 weeks from the parent study (N
=76). We will evaluate whether there is a modification from baseline in candidate innate immune
activation/inflammatory pathways through targeted whole genomic transcriptional profiling and plasma
biomarkers in (a) depression remitters (defined as Quick Inventory of Depressive Symptomatology score -
QIDS-SR ≤5) vs. non-remitters; and (b) responders to treatment (defined as a decrease in the QIDS-SR score
by ≥3 points from baseline) vs. non-responders to treatment. Aim 2. Assess underlying facilitators of or
barriers to behavior adoption, in this case adherence to MDD treatment interventions (drug by pill count
and BAT teletherapy sessions), in patients with CKD. We will conduct focus groups in 50 participants who have
finished the 16-week trial to gather data on participants’ experiences, barriers to and facilitators of intervention
engagement and adherence, and perceived benefits of the intervention. Aim 3. Assess maintenance of MDD
treatment response over time, beyond the 16-week active intervention period (N =50), in remitters vs.
non-remitters at 8 weeks, by assessing improvement in patient-centered outcomes of (a) depressive
symptoms; (b) fatigue; (c) sleep; (d) overall functioning. This application corresponds with my parent R01’s
scope and timeline and t...

## Key facts

- **NIH application ID:** 10667222
- **Project number:** 3R01DK124379-03S1
- **Recipient organization:** UT SOUTHWESTERN MEDICAL CENTER
- **Principal Investigator:** Susan Hedayati
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $426,044
- **Award type:** 3
- **Project period:** 2022-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10667222

## Citation

> US National Institutes of Health, RePORTER application 10667222, Mechanisms for Behavior Change and Maintenance of Treatment for CKD Comorbid Depression (3R01DK124379-03S1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10667222. Licensed CC0.

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