title: Relationship between depressive affect and malnutrition-inflammation complex syndrome in haemodialysis patients.
abstract: BACKGROUND
  Depression is associated with high mortality in haemodialysis (HD) patients, and can be associated with the poor oral intake that contributes to malnutrition. Malnutrition-inflammation complex syndrome (MICS) causes increased morbidity and mortality in HD patients. We investigated relationships between depressive affect, social support and various components of MICS in HD patients.
  
  
  METHODS
  The subjects were 110 patients (65 men and 45 women, mean age 45.39 +/- 14.73 years) on maintenance HD. The Beck Depression Inventory (BDI), Cognitive Depression Index (CDI), and the Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess aspects of depressive affect in each subject.
  
  
  RESULTS
  The mean dialysis duration was 53.04 +/- 38.15 months. The mean BDI and CDI scores were 12.10 +/- 7.43 and 8.40 +/- 5.72, respectively. Patients were divided into two subgroups according to CDI score (depressive affect >10 (n = 71) and non-depressive affect <or=10 (n = 39)). CDI score was correlated with malnutrition-inflammation score (MIS) (r = 0.24; P < 0.05), haemoglobin level (r = -0.23; P < 0.05) and MSPSS score (r = -0.28; P < 0.01). The subgroup with depressive affect had higher MIS (P < 0.01) and lower social support (P = 0.001) than the non-depressive affect group. Logistic regression analysis identified high MIS and low MSPSS score as independent risk factor for depression.
  
  
  CONCLUSIONS
  The results suggest that MIS and MSPSS are the strongest predictors of depressive affect in HD patients. Further research is needed to understand the causal relationship between depressive affect and MICS in HD patients.
authors.affiliation: Department of Nephrology, Başkent University Faculty of Medicine, Hospital of Adana, Adana, Turkey. hasanmicoz@hotmail.com
authors.forename: Hasan
authors.initials: H
authors.lastname: Micozkadioglu
authors.forename: Irem
authors.initials: I
authors.lastname: Micozkadioglu
authors.forename: Aysegul
authors.initials: A
authors.lastname: Zumrutdal
authors.forename: Abdullah
authors.initials: A
authors.lastname: Erdem
authors.forename: Fatma Nurhan
authors.initials: FN
authors.lastname: Ozdemir
authors.forename: Siren
authors.initials: S
authors.lastname: Sezer
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000453:epidemiology* / Q000523:psychology; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D010555:Personality Inventory; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000523:psychology / Q000706:statistics & numerical data*; D012307:Risk Factors; D012944:Social Support