Relationship between depressive affect and malnutrition-inflammation complex syndrome in haemodialysis patients.
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.
Micozkadioglu
Hasan
H
Department of Nephrology, Başkent University Faculty of Medicine, Hospital of Adana, Adana, Turkey. hasanmicoz@hotmail.com
Micozkadioglu
Irem
I
Zumrutdal
Aysegul
A
Erdem
Abdullah
A
Ozdemir
Fatma Nurhan
FN
Sezer
Siren
S
Haberal
Mehmet
M
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