An association between residual renal function and depression symptoms in haemodialysis patients.
BACKGROUND
The loss of residual renal function (RRF) and subsequent urine volume among haemodialysis (HD) patients may influence affect. Although RRF has been associated with improved patient outcome, its relationship with depression symptomatology is unknown.


METHODS
106 HD patients completed the Beck Depression Inventory (BDI). The BDI is a depression symptom screening tool, with a score of >or=16 indicating possible clinical depression. Clinical parameters, including RRF (urea clearance, KRU [ml/min]) and interdialytic urine volume, were averaged over the 3-month pre-assessment including the month of the BDI assessment.


RESULTS
BDI scores correlated negatively with KRU and interdialytic urine volume. Patients with a KRU <1 had significantly higher BDI scores compared to those with a KRU >or=1. In logistic regression, KRU significantly predicted a BDI score >or=16, after controlling for a range of clinical parameters including urea, dialysis vintage and treatment time. A history of depressive illness was the only other predictive factor.


CONCLUSIONS
We have demonstrated an association between RRF and depression symptoms in HD patients. The perception of loss associated with low RRF and urine volume may increase depressive vulnerability. Longitudinal assessment is required in order to validate this finding and to determine causality.
Chilcot
Joseph
J
Renal Unit Lister Hospital, Stevenage, UK. josephchilcot@nhs.net
Wellsted
David
D
Vilar
Enric
E
Farrington
Ken
K
D015897:Comorbidity; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*; D007677:Kidney Function Tests / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000523:psychology* / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology