Hypertension – A Possible Vulnerability Marker for Depression in Patients with End-Stage Renal Disease

Abstract

Objective:This study explored the association of hypertension and psychiatric morbidity in patients with end-stage renal disease (ESRD) under adjusted personality characteristics and parental attachment. Methods: The mental health of 121 patients with ESRD in a general teaching hospital was evaluated using the 12-item version of the Chinese Health Questionnaire (CHQ). Only 40 males and 49 females completed all the questionnaires. Ten of the 40 males and 21 of the 49 females had high scores (≧4) and were allotted to the case group (n = 31). The remaining 58 patients constituted the control group (CHQ <4). Results: The logistic regression model showed that hypertension, gender, and neuroticism are statistically significant covariates. Hypertension, especially, was strongly associated with depressive vulnerability (odds ratio of hypertension versus without hypertension = 9.07:1). Structural equation modeling revealed that gender difference and hypertension directly influenced the individuals’ mental health status and that the influence of hypertension on mental health was highly variable. Conclusion:A parsimonious structural equation model provided considerable evidence that hypertension could have an important effect on depression in ESRD patients, when predisposing factors, such as personality characteristics and parental attachment, gender, duration of hemodialysis and other medical diseases were adjusted. Hence, hypertension might be a mediating factor of depressive vulnerability in ESRD patients underling genetic and environmental problems.

Impact of personality and psychological distress on health-related quality of life in kidney transplant recipients

“…Patients who have anxious and depressive symptoms describe their quality of life as worse. This finding supports previous findings stressing the impact of depression and anxiety on HRQoL evaluation [25,36]. According to some authors, the levels of anxiety do not diminish after KT, because the anxiety generated by dialysis is replaced with graft-loss anxiety, anxiety related to adjustment to life after KT and to treatment effects [37].…”

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. However, little is known about the relationship between depression and inflammatory biomarkers and cardiovascular risk factors, especially in patients treated with peritoneal dialysis.…”

Telomere length may be associated with hypertension

“…PCR was performed on a real-time PCR machine (RAPID, ID, Salt Lake City, UT, USA). The thermal cycling profile for the telomere amplification was 95 1C for 10 …”

“…Therefore, the question whether telomere length or hypertension affects remains unanswered. In addition, hypertensive patients have nine times greater risk of being depressed, 10 and depression has an effect on telomeric shortening. 11 Depression could be a confounder of the relationship between telomere length and hypertension; however, further investigation of this topic may be warranted.…”