title: Survey of depression by Beck Depression Inventory in uremic patients undergoing hemodialysis and hemodiafiltration.
abstract: High prevalence of depression has been reported in patients with end stage kidney disease and depression is associated with increased morbidity and mortality. We aimed to investigate the prevalence of depression in patients receiving standard hemodialysis (SHD) and hemodiafiltration (HDF) and compare the associated factors between these treatment modalities. The Beck Depression Inventory (BDI) was used to survey for major depressive symptoms. Demographic and biochemical data were reviewed and collected. Point prevalence of depression in HDF patients was significantly lower than SHD patients (23.9% vs. 43.1%, P < 0.05). The BDI score was also higher in SHD than HDF group (13.2 ± 11.6 vs. 8.7 ± 11.2, P < 0.05). SHD patients with major depressive symptoms had significantly lower levels of hemoglobin, albumin, creatinine, sodium and hand grip strength but had higher prevalence of diabetes and high sensitivity C-reactive protein (hs-CRP) levels. In HDF patients, phosphorus level was significantly lower in patients with major depressive symptoms. Logistic regression analysis revealed that hs-CRP, serum sodium and hand grip strength were significantly associated with major depressive symptoms in patients treated with SHD; while serum phosphorus was identified in HDF groups. We concluded that prevalence of depression was high in dialysis patients. Patients receiving HDF had a lower mean BDI score and a nearly 50% lower prevalence rate of major depressive symptoms than that of SHD. Factors associated with depression were different between two modalities.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Su
authors.forename: Hwee-Yeong
authors.initials: HY
authors.lastname: Ng
authors.forename: Tiao-Lai
authors.initials: TL
authors.lastname: Huang
authors.forename: Po-Jui
authors.initials: PJ
authors.lastname: Chi
authors.forename: Yueh-Ting
authors.initials: YT
authors.lastname: Lee
authors.forename: Chun-Ren
authors.initials: CR
authors.lastname: Lai
authors.forename: Yau-Hsing
authors.initials: YH
authors.lastname: Lin
authors.forename: Pei-Chen
authors.initials: PC
authors.lastname: Huang
authors.forename: Chien-Te
authors.initials: CT
authors.lastname: Lee
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D018737:Hand Strength; D017583:Hemodiafiltration; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010758:Phosphorus / Q000097:blood; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D006435:Renal Dialysis; D012964:Sodium / Q000097:blood; D014511:Uremia / Q000453:epidemiology
chemical_list: D006454:Hemoglobins; D010758:Phosphorus; D002097:C-Reactive Protein; D012964:Sodium