title: Relation between depression, some laboratory parameters, and quality of life in hemodialysis patients.
abstract: Depression is common in patients with end-stage renal disease (ESRD) and is associated with increased mortality and morbidity. Several investigators have estimated that depression occurs in about 20% to 30% of dialysis patients. The aim of this study was to investigate the relationship between depression, some laboratory parameters, and quality of life (QOL) in hemodialysis patients. Forty-three hemodialysis patients (mean age 40.5+/-15.2; M=28, F=15) were included in the study. Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and short form with 36 (SF-36) were used for evaluation. Subsequently, patients were divided into two groups according to HAMD scores: group 1, those who had a low HAMD score (between 0 and 7), and group 2, those who had a high HAMD score (over 7). The two groups were compared in terms of anxiety scores, QOL scores, and some laboratory parameters. The group 2 patients (n=21; M= 13, F=8) had lower levels of hemoglobin than the group 1 patients (9.5+/-1.7 vs. 10.7+/- 1.4 g/dL, respectively; p<0.01). Group 2 patients also had lower SF-36 scores than group 1 patients (91.5+/-21.3 vs. 74.9+/- 13.6, respectively; p=0.03). On the contrary, the patients of group 2 had higher HAMA scores than group 1 patients (16.6+/-6.9 vs. 6.3+/-3.5, respectively; p<0.01) and CRP level (10.7+/-4.6 vs. 4.5+/-3.8, respectively; p<0.001). A significant correlation was found between depression scores and C-reactive protein (CRP) (r= 0.57, p < 0.001) and HAMA scores (r=-0.43, p<0.05). In contrast, a negative correlation was found between HAMD scores and albumin (r=-0.43, p<0.05), hemoglobin (r=-0.38, p=0.015) and SF-36 scores (r=0.39, p=0.032). These findings demonstrate that there is a relationship among high depression score, low levels of hemoglobin and albumin, high CRP level, low SF-36 score, and high anxiety score. Evaluation of psychiatric status should be part of the care provided to hemodialysis patients.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Medical Faculty, Kahramanmaras Sutcu Imam, Turkey. ekremdogan68@yahoo.com
authors.forename: Ekrem
authors.initials: E
authors.lastname: Dogan
authors.forename: Reha
authors.initials: R
authors.lastname: Erkoc
authors.forename: Buket
authors.initials: B
authors.lastname: Eryonucu
authors.forename: Hayriye
authors.initials: H
authors.lastname: Sayarlioglu
authors.forename: Mehmet Y A
authors.initials: MY
authors.lastname: Agargun
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000328:Adult; D001774:Blood Chemical Analysis; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D006435:Renal Dialysis / Q000379:methods / Q000523:psychology*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome