Depressive Symptoms and Proinflammatory Cytokine Levels in Chronic Renal Failure Patients

Abstract

Background/Aims: Cytokine secretion is known to play an important role in the pathophysiology of depression, and levels of proinflammatory cytokines are increased in chronic renal failure (CRF) patients. The objective of this study was to examine the correlation between levels of proinflammatory cytokines in CRF patients and degree of depression. Methods: 31 patients on hemodialysis, 31 patients on continuous ambulatory peritoneal dialysis, and 31 conservatively managed chronic kidney disease (CKD) patients were enrolled in this study. Depressive symptoms were measured with the Beck Depression Inventory (BDI), and ‘elevated symptoms of depression’ were defined as a BDI score ≧17. IL-6 and TNFα cytokine levels were measured by ELISA. Results: ‘Elevated symptoms of depression’ occurred in 37 of 93 patients (40%). IL-6 and TNFα levels were not significantly different among CRF patients with and without elevated depressive symptoms (p = 0.937 and p = 0.414, respectively). When analyzed by treatment subgroup, proinflammatory cytokine levels were not significantly different in patients with and without elevated symptoms of depression. Conclusion: In patients with CRF, elevated symptoms of depression were not associated with increased cytokine levels.

Responses of Human Skin in Organ Culture and Human Skin Fibroblasts to a Gadolinium-Based MRI Contrast Agent

“…Hyaluronan synthesis is also influenced by the MAP kinase signaling (both p38 and ERK contributing) (56). Since these same signaling pathways are stimulated by a number of pro-inflammatory cytokines, proinflammatory mediators elaborated in renal failure (16,17,57,58) may contribute to the increased background levels of enzyme and inhibitor as well as increased hyaluronan in these patients. As noted above, studies by Wermuth et al (36) and by Steger-Hartmann et al (37) have demonstrated production of pro-inflammatory cytokines in response to GBCA treatment.…”

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

“…In the general population, depression is known to increase the incidence and worsen the outcome of cardiovascular diseases [13], and a correlation between depression, malnutrition and inflammation has been reported in patients with chronic kidney disease [14,15,16]. Considering the fact that inflammation is an important mediator for cardiovascular disease, there is a possibility that depression might contribute to increased cardiovascular mortality and morbidity in ESRD patients [17,18] by aggravating malnutrition-inflammation-atherosclerosis (MIA) interactions.…”

Association between depression and malnutrition–inflammation complex syndrome in patients with continuous ambulatory peritoneal dialysis

“…Our current study found that depression and malnutrition were closely related in PD patients; depressed patients had significantly lower serum albumin levels than non-depressed patients. There is also evidence that depression is accompanied by activation of the pro-inflammatory cytokines, which may have a role in causation of depression [13,19], and may lead to increased protein catabolism, poor oral intake, and malnutrition. Smith put forward the ''macrophage theory of depression'' in 1991, in which excessive secretion of macrophage-derived cytokines was proposed as the cause of depression [20].…”

“…Together they are referred to as the malnutrition-inflammation complex syndrome (MICS) [10,11]. Some previous studies have shown that depression is associated with decreased food intake [12] and activated inflammatory response [5,13]. However, there is still insufficient data about the relation between depression and MICS, especially in peritoneal dialysis (PD) patients.…”