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01.09.2011 | Nephrology – Original Paper

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

verfasst von: Zhi-Jian Li, Xin An, Hai-Ping Mao, Xin Wei, Jie-Hui Chen, Xiao Yang, Shu-Feng Zhou, Zhi-Bin Li, Xue-Qing Yu

Erschienen in: International Urology and Nephrology | Ausgabe 3/2011

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Abstract

Objective

Depression, the most common psychological disorder among patients with end-stage renal disease (ESRD), is associated with poor survival. The prevalence of depression and its relation with the malnutrition–inflammation complex syndrome (MICS) have not yet been clearly defined in Chinese continuous ambulatory peritoneal dialysis (CAPD) patients.

Patients and methods

A total of 142 patients on CAPD were enrolled in the First Affiliated Hospital of Sun Yat-Sen University. The Hamilton Depression Scale (HAMD) and the malnutrition–inflammation score (MIS) were used for depression and MICS evaluation, respectively. Clinical, socioeconomic, and malnutrition–inflammation factors were compared among patients with and without depression. Binary regression analysis was performed to investigate the independent association between depression and MICS.

Results

The mean HAMD and MIS scores were 7.12 ± 5.28 and 4.45 ± 3.56, respectively. According to HAMD, 37 patients (26.1%) had depression and 70 patients (49.3%) had potential depression. Older age, longer dialysis vintage, worse residual renal function, lower employment and reimbursement status, and higher comorbidity index were positively correlated with depression. Compared to non-depressed patients, the depressed ones also showed lower levels of serum albumin and higher levels of C-reactive protein (CRP). Correlation results showed that the HAMD scores were significantly and positively correlated with MIS (r = 0.46, P < 0.01). Moreover, the incidence of peritonitis was significantly higher in depressed compared to non-depressed patients. Binary regression analysis showed that MIS was the only independent risk factor for depression.

Conclusion

Depression is commonly encountered in Chinese CAPD patients. A close relationship exists between depression and MICS.

Cukor D, Cohen SD, Peterson RA et al (2007) Psychosocial aspects of chronic disease: ESRD as a paradigmatic illness. J Am Soc Nephrol 18(12):3042–3055PubMedCrossRef

Chen YS, Wu SC, Wang SY et al (2003) Depression in chronic haemodialysed patients. Nephrology (Carlton) 8(3):121–126CrossRef

Kimmel PL, Emont SL, Newmann JM et al (2003) ESRD patient quality of life: symptoms, spiritual beliefs, psychosocial factors, and ethnicity. Am J Kidney Dis 42(4):713–721PubMedCrossRef

Ibrahim S, El Salamony O (2008) Depression, quality of life and malnutrition-inflammation scores in hemodialysis patients. Am J Nephrol 28(5):784–791PubMedCrossRef

Kalender B, Dervisoglu E, Sengul E et al (2007) Depression, nutritional status, and serum cytokines in peritoneal dialysis patients: is there a relationship? Perit Dial Int 27(5):593–595PubMed

Finkelstein FO, Finkelstein SH (2000) Depression in chronic dialysis patients: assessment and treatment. Nephrol Dial Transplant 15(12):1911–1913PubMedCrossRef

Kimmel PL, Peterson RA, Weihs KL et al (2000) Multiple measurements of depression predict mortality in a longitudinal study of chronic hemodialysis outpatients. Kidney Int 57(5):2093–2098PubMedCrossRef

Herselman M, Moosa MR, Kotze TJ et al (2000) Protein-energy malnutrition as a risk factor for increased morbidity in long-term hemodialysis patients. J Ren Nutr 10(1):7–15PubMedCrossRef

Ravnskov U (2004) Inflammation, cholesterol levels, and risk of mortality among patients receiving dialysis. Jama 291(15):1833–1834 author reply 1834–1835PubMedCrossRef

10.

Kalantar-Zadeh K, Ikizler TA, Block G et al (2003) Malnutrition-inflammation complex syndrome in dialysis patients: causes and consequences. Am J Kidney Dis 42(5):864–881PubMedCrossRef

11.

Stenvinkel P, Heimburger O, Lindholm B et al (2000) Are there two types of malnutrition in chronic renal failure? Evidence for relationships between malnutrition, inflammation and atherosclerosis (MIA syndrome). Nephrol Dial Transplant 15(7):953–960PubMedCrossRef

12.

Koo JR, Yoon JW, Kim SG et al (2003) Association of depression with malnutrition in chronic hemodialysis patients. Am J Kidney Dis 41(5):1037–1042PubMedCrossRef

13.

Dervisoglu E, Kir HM, Kalender B et al (2008) Depressive symptoms and proinflammatory cytokine levels in chronic renal failure patients. Nephron Clin Pract 108(4):c272–c277PubMedCrossRef

14.

Devereaux PJ, Schunemann HJ, Ravindran N et al (2002) Comparison of mortality between private for-profit and private not-for-profit hemodialysis centers: a systematic review and meta-analysis. Jama 288(19):2449–2457PubMedCrossRef

15.

Kalender B, Ozdemir AC, Koroglu G (2006) Association of depression with markers of nutrition and inflammation in chronic kidney disease and end-stage renal disease. Nephron Clin Pract 102(3–4):c115–c121PubMedCrossRef

16.

Shayamsunder AK, Patel SS, Jain V et al (2005) Sleepiness, sleeplessness, and pain in end-stage renal disease: distressing symptoms for patients. Semin Dial 18(2):109–118PubMedCrossRef

17.

Einwohner R, Bernardini J, Fried L et al (2004) The effect of depressive symptoms on survival in peritoneal dialysis patients. Perit Dial Int 24(3):256–263PubMed

18.

Kalantar-Zadeh K, Supasyndh O, Lehn RS et al (2003) Normalized protein nitrogen appearance is correlated with hospitalization and mortality in hemodialysis patients with Kt/V greater than 1.20. J. Ren Nutr 13(1):15–25CrossRef

19.

Bossola M, Tazza L, Luciani G (2009) Mechanisms and treatment of anorexia in end-stage renal disease patients on hemodialysis. J Ren Nutr 19(1):2–9PubMedCrossRef

20.

Smith RS (1991) The macrophage theory of depression. Med Hypotheses 35(4):298–306PubMedCrossRef

21.

O’Brien SM, Scott LV, Dinan TG (2004) Cytokines: abnormalities in major depression and implications for pharmacological treatment. Hum Psychopharmacol 19(6):397–403PubMedCrossRef

22.

Lee SK, Lee HS, Lee TB et al (2004) The effects of antidepressant treatment on serum cytokines and nutritional status in hemodialysis patients. J Korean Med Sci 19(3):384–389PubMedCrossRef

23.

Tuglu C, Kara SH, Caliyurt O et al (2003) Increased serum tumor necrosis factor-alpha levels and treatment response in major depressive disorder. Psychopharmacology (Berl) 170(4):429–433CrossRef

24.

Ho LC, Wang HH, Peng YS et al (2008) Clinical utility of malnutrition-inflammation score in maintenance hemodialysis patients: focus on identifying the best cut-off point. Am J Nephrol 28(5):840–846PubMedCrossRef

25.

Rambod M, Kovesdy CP, Kalantar-Zadeh K (2008) Malnutrition-Inflammation Score for risk stratification of patients with CKD: is it the promised gold standard? Nat Clin Pract Nephrol 4(7):354–355PubMedCrossRef

26.

Afsar B, Sezer S, Ozdemir FN et al (2006) Malnutrition-inflammation score is a useful tool in peritoneal dialysis patients. Perit Dial Int 26(6):705–711PubMed

27.

Kalantar-Zadeh K, Kopple JD, Block G et al (2001) A malnutrition-inflammation score is correlated with morbidity and mortality in maintenance hemodialysis patients. Am J Kidney Dis 38(6):1251–1263PubMedCrossRef

28.

Afsar B, Sezer S, Elsurer R et al (2008) Malnutrition-inflammation score in peritoneal dialysis: growing reliability. Perit Dial Int 28(2):207PubMed

29.

Micozkadioglu H, Micozkadioglu I, Zumrutdal A et al (2006) Relationship between depressive affect and malnutrition-inflammation complex syndrome in haemodialysis patients. Nephrology (Carlton) 11(6):502–505CrossRef

30.

Chung SH, Heimburger O, Stenvinkel P et al (2003) Association between residual renal function, inflammation and patient survival in new peritoneal dialysis patients. Nephrol Dial Transplant 18(3):590–597PubMedCrossRef

31.

Wang AY, Sea MM, Ip R et al (2001) Independent effects of residual renal function and dialysis adequacy on actual dietary protein, calorie, and other nutrient intake in patients on continuous ambulatory peritoneal dialysis. J Am Soc Nephrol 12(11):2450–2457PubMed

32.

Mahajan S, Tiwari SC, Kalra V et al (2007) Analysis of depression and its effect on outcome among adult Indian peritoneal dialysis patients. Perit Dial Int 27(1):94–96PubMed

33.

de Groot M, Anderson R, Freedland KE et al (2001) Association of depression and diabetes complications: a meta-analysis. Psychosom Med 63(4):619–630PubMed

34.

Troidle L, Watnick S, Wuerth DB et al (2003) Depression and its association with peritonitis in long-term peritoneal dialysis patients. Am J Kidney Dis 42(2):350–354PubMedCrossRef

Titel: Association between depression and malnutrition–inflammation complex syndrome in patients with continuous ambulatory peritoneal dialysis
verfasst von: Zhi-Jian Li
Xin An
Hai-Ping Mao
Xin Wei
Jie-Hui Chen
Xiao Yang
Shu-Feng Zhou
Zhi-Bin Li
Xue-Qing Yu
Publikationsdatum: 01.09.2011
Verlag: Springer Netherlands
Erschienen in: International Urology and Nephrology / Ausgabe 3/2011
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-011-9917-x

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