[Poor adherence to diet in hemodialysis: role of anxiety and depression symptoms].
OBJECTIVE
To determine whether symptoms of anxiety or depression are factors associated with poor compliance of fluid restriction and dietary selection in chronic renal failure patients in hemodialysis.


METHODS
A cross-sectorial, descriptive, comparative and correlation study was designed between january and march of 2000, patients were selected in 3 hemodialysis centers of Social Security in Lima with Karnofsky index > 80, without an acute failure of treatment or default from therapy in the last 3 months. Depressive symptoms were evaluated with Beck Depression Inventory and Anxiety Symptoms with the Zung Scale. Poor compliance with fluid restriction was defined as an interdialytic weight gain > or = 2.5 kg and dietary restriction as a level of predialysis serum potassium > or = 6 meq/L. The evaluation of risk factors was made with a simple and multiple logistic regression analysis.


RESULTS
Eighty eight patients were selected, 47 (53.4%) were men, the average values of age, time on dialysis, level of creatinine and hemoglobin were respectively 55.9 +/- 15.8 years old, 48.8 +/- 38.8 months, 8.5 +/- 1.9 mg/dl and 7.7 +/- 1.4 g/dl. The number of patients with adequacy of dialysis, depressive symptoms, anxiety symptoms, poor compliance with fluid restriction and dietary selection were respectively 50 (62.5%), 54 (61.4%), 46 (52.3%), 47 (53.4%) and 31 (35.2%). The multiple logistic regression analysis showed that depressive symptoms are the only factor associated with poor compliance with fluid restriction (OR = 2.7, p = 0.002) and dietary selection (OR = 2.5, p = 0.0067). Depressive symptoms and them severity had a positive correlation with poor compliance.


CONCLUSIONS
Depressive symptoms and its severity is associated with a higher interdialitytic weight gain and higher predialysis serum potassium in hemodialysis patients. Early diagnosis and therapeutic intervention might benefit these patients.
Universidad Peruana Cayetano Heredia, Lima, Perú.
F W
FW
García Valderrama
C
C
Fajardo
R
R
Guevara
V
V
Gonzáles Pérez
A
A
Hurtado
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000523:psychology*; D016312:Treatment Refusal / Q000523:psychology*