Depression, quality of life, and body composition in patients with end-stage renal disease: a cohort study

Abstract

Objective: To prospectively evaluate depressive symptoms, nutritional status, and quality of life (QoL) and search for possible associations in patients with end-stage renal disease undergoing hemodialysis. Methods: A cohort study of 104 adult patients with end-stage renal disease undergoing hemodialysis was conducted. Anthropometric, clinical, and biochemical variables were evaluated after a midweek hemodialysis session. The participants' body composition was assessed by direct segmental multifrequency bioimpedance analysis. The WHOQOL-Bref questionnaire was used to evaluate QoL. Participants were separated into two groups -depressive symptoms and no depressive symptoms -at inclusion and evaluated annually for 2 years thereafter using the Beck Depression Inventory. Survival analysis used the Kaplan-Meier method and Cox regression analysis for the goodness of fit of associated factors. All-cause mortality was the outcome of interest. Results: Participants' mean age was 55.3615.6 years, 60% were male, and the median time on hemodialysis was 17.5 (8.0-36.8) months. Thirty-two patients had depressive symptoms and a significantly lower QoL compared with the 72 patients in the no depressive symptoms group. The fitted outcome model showed that lean body mass had a protective effect against all-cause mortality (hazard ratio [HR] = 0.89; 95%CI 0.80-0.99; p = 0.038). Conclusion: Depressive symptoms were highly prevalent in the cohort, and correlated with the physical and psychological components of the QoL life questionnaire, as well as with C-reactive protein and phosphorus levels. Lean body mass was protective for the assessed outcome.

Depression and anxiety among patients undergoing dialysis and kidney transplantation: a cross-sectional study

“…Negative correlations between emotional disorders and quality of life domains have been widely reported. [14][15][18][19][20][21][22] Perales Montilla et al 41 compared the capacity of self-reported somatic symptoms and depression and anxiety for predicting quality of life among patients with chronic renal disease. Their results indicated that mood was a predictor of reductions in the physical and mental components of the SF-36, compared with the number and severity of physical symptoms.…”

The screening score of Mini Nutritional Assessment (MNA) is a useful routine screening tool for malnutrition risk in patients on maintenance dialysis

“…In dialysis patients, insufficient nutritional intake, compromised clinical well-being, comorbidity and dialysis related factors can lead to poor nutritional status [4][5][6]. Poor nutritional status is on its turn associated with impaired functional capacity, increased risk of complications, lower quality of life and limited survival [3,[7][8][9]. Therefore it seems important to identify patients at risk for malnutrition already at an early stage, in order to start interventions to improve their nutritional status and clinical and mental outcome.…”

Association Between Serum Uric Acid and Depression in Patients with Chronic Kidney Disease not Requiring Kidney Dialysis: Cross-Sectional and Longitudinal Analyses

“…A relationship between inflammation, malnutrition, and depression has been previously proposed [ 9 – 13 ]. However, our study did not identify any impact of BMI, serum Alb, Hb, TC, or TG on depression.…”

“…Previous studies have shown that economic and social factors are associated with depression and health-related QoL in patients with CKD [ 8 ]. Other studies have found that nutrition and inflammation also impact psychological disorders in patients with CKD and other patient populations [ 9 – 13 ].…”