Depression in hemodialysis patients: association with inflammatory and nutritional markers

Abstract

Depression, malnutrition and inflammation are highly prevalent in hemodialysis (HD) patients, representing important predictors of morbidity and mortality.

The aim of the study was to screen for depression in HD patients and analyze, among other factors, its association with inflammatory and nutritional indices. C-reactive protein, Body Mass Index, albumin, cholesterol, phosphate and hemoglobin levels, dialysis adequacy, the presence of co-morbidities, stages of rehabilitation, education level and marital status were observed.

Thirty five patients (19F,16M) aged 53.1±9.4 years, on thrice-weekly HD for 77.7±57.1 months were studied. Depression was assessed via Beck Depression Inventory (BDI). The scores on the BDI ranged from 0 to 45 (16.9±11.1). 31.4% and 28.6% prevalences of inflammation and malnutrition were observed.

Patients were divided into two groups according to score obtained: 9 not depressed (NonD) subjects (2F, 7M, BDI 0-9) and 26 patients (17F, 9M) with depressive symptoms (D group, score of 10+). Depression was significantly more frequent in females (p=0.05). None of the patients working full or part time had depressive symptoms, as opposed to 3 without job and 13 who were retired (p=0.02). Insignificant diference in prevalence of inflammation, malnutrition and other analyzed parameters was found. Subdivision of D group revealed mild depressive patients (10-15) to be significantly younger than both nonD patients and subjects with moderate or severe depression (16 +); p= 0.02.

Depression, inflammation and malnutrition are common in HD patients. It is of great importance for long-term outcome of this population to identify them early and initiate treatment.