title: Association between depression and malnutrition-inflammation complex syndrome in patients with continuous ambulatory peritoneal dialysis.
abstract: OBJECTIVE
  Depression, the most common psychological disorder among patients with end-stage renal disease (ESRD), is associated with poor survival. The prevalence of depression and its relation with the malnutrition-inflammation complex syndrome (MICS) have not yet been clearly defined in Chinese continuous ambulatory peritoneal dialysis (CAPD) patients.
  
  
  METHODS
  A total of 142 patients on CAPD were enrolled in the First Affiliated Hospital of Sun Yat-Sen University. The Hamilton Depression Scale (HAMD) and the malnutrition-inflammation score (MIS) were used for depression and MICS evaluation, respectively. Clinical, socioeconomic, and malnutrition-inflammation factors were compared among patients with and without depression. Binary regression analysis was performed to investigate the independent association between depression and MICS.
  
  
  RESULTS
  The mean HAMD and MIS scores were 7.12 ± 5.28 and 4.45 ± 3.56, respectively. According to HAMD, 37 patients (26.1%) had depression and 70 patients (49.3%) had potential depression. Older age, longer dialysis vintage, worse residual renal function, lower employment and reimbursement status, and higher comorbidity index were positively correlated with depression. Compared to non-depressed patients, the depressed ones also showed lower levels of serum albumin and higher levels of C-reactive protein (CRP). Correlation results showed that the HAMD scores were significantly and positively correlated with MIS (r = 0.46, P < 0.01). Moreover, the incidence of peritonitis was significantly higher in depressed compared to non-depressed patients. Binary regression analysis showed that MIS was the only independent risk factor for depression.
  
  
  CONCLUSIONS
  Depression is commonly encountered in Chinese CAPD patients. A close relationship exists between depression and MICS.
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, 58th Zhongshan 2nd Road, Guangzhou 510080, People's Republic of China.
authors.forename: Zhi-Jian
authors.initials: ZJ
authors.lastname: Li
authors.forename: Xin
authors.initials: X
authors.lastname: An
authors.forename: Hai-Ping
authors.initials: HP
authors.lastname: Mao
authors.forename: Xin
authors.initials: X
authors.lastname: Wei
authors.forename: Jie-Hui
authors.initials: JH
authors.lastname: Chen
authors.forename: Xiao
authors.initials: X
authors.lastname: Yang
authors.forename: Shu-Feng
authors.initials: SF
authors.lastname: Zhou
authors.forename: Zhi-Bin
authors.initials: ZB
authors.lastname: Li
authors.forename: Xue-Qing
authors.initials: XQ
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D003863:Depression / Q000150:complications* / Q000523:psychology; D004651:Employment / Q000523:psychology; D005260:Female; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000523:psychology; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000523:psychology*; D010538:Peritonitis / Q000150:complications* / Q000523:psychology; D012044:Regression Analysis; D012709:Serum Albumin / Q000378:metabolism; D055815:Young Adult
chemical_list: D012709:Serum Albumin; D002097:C-Reactive Protein