Association between Depression Symptoms with Inflammation and Cardiovascular Risk Factors in Patients Undergoing Peritoneal Dialysis

Abstract

Despite medical progress, high morbidity and mortality rates, due primarily to cardiovascular diseases, have persisted in patients with end-stage renal disease (ESRD). Recently, nontraditional risk factors, such as inflammation and malnutrition, have been emphasized in the development or progression of atherosclerosis in ESRD patients. Depression, the most common psychological problem in the ESRD population, is also known to be associated with inflammation and malnutrition, suggesting a possible link between depression with inflammation and cardiovascular diseases. The purpose of this study was to investigate the relationship between depression with cardiovascular risk factors and inflammation in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Eighty-one stable CAPD patients were enrolled. Depressive symptoms were assessed with the Beck Depression Inventory. Various cardiovascular risk factors and inflammatory markers were measured. Forty-three patients had depressive symptoms (53.8%). Patients with depressive symptoms showed significantly lower levels of albumin and IL-10, but higher levels of inflammatory markers than patients without depressive symptoms. Left ventricular hypertrophy was also found more frequently and pulse wave velocity and asymmetric dimethylarginine were all significantly increased in patients with depressive symptoms. Depression in CAPD patients was associated with inflammation and cardiovascular risk factors, and might be used as a predictor of cardiovascular diseases.

Serum apelin is associated with affective disorders in peritoneal dialysis patients

“…27 Also, Ko et al found that hsCRP significantly affected BDI score in CAPD patients, suggesting a strong association between inflammation and depression. 28 In another study using The Hamilton Depression Scale (HAMD), serum CRP closely correlated with depression score in CAPD patients. 29 However, other studies could not demonstrate such a relationship between CRP and inflammation.…”

Therapeutics targeting persistent inflammation in chronic kidney disease

“…32,33 In peritoneal dialysis (PD) patients, depression was strongly related to inflammation, malnutrition, and multiple cardiovascular risk factors, suggesting that depression is an integral part of the MIA syndrome. 34 Indeed the state of depression associates with activation of proinflammatory cytokines, and patients on maintenance HD with symptoms of depression were more likely to have high levels of serum IL-6, higher prevalence of comorbidities, higher serum total cholesterol, and lower s-albumin levels. 35 In depressed HD patients, sertraline, a selective serotonin reuptake inhibitor antidepressant, was found to have antiinflammatory effects in addition to improving depression symptoms in almost half of the HD patients.…”

Psychosocial risk and protective factors for depression in the dialysis population: A systematic review and meta-regression analysis

“…Disease-specific factors that have been found to be associated with depression include the characteristics of dialysis received [11][12][13][14], dialysis adequacy [15], kidney disease [16], restless leg syndrome [17], as well as markers of creatinine, haemoglobin and serum albumin [15,18,19]. With respect to patient status, physical functioning [20,21], exercise fitness [22,23], cytokines [18,24,25], disease comorbidity [19], nutrition [15,26], sleep problems [27], and fatigue [28] have all been linked to depression.…”