title: Cancer patients under maintenance hemodialysis: relationship between quality of life, depression, sleep quality and malnutrition-inflammation score.
abstract: BACKGROUND
  The kidney is one major organ affected by cancer and its associated therapies. The aim of this study was to compare the levels of depression, quality of life and sleep quality in hemodialysis patients with or without cancer, and to analyze the associations with the malnutrition-inflammation score (MIS).
  
  
  METHODS
  In this cross-sectional study, 40 cancer patients under hemodialysis and 44 patients under hemodialysis without cancer who served as the control group were included. Participants underwent structured interviews to investigate depression, quality of life, sleep quality and restless legs syndrome.
  
  
  RESULTS
  Hemodialysis patients with cancer had a greater depression score (16.5 ± 4.8 vs. 10.8 ± 5.2, p < 0.001). Patients had similar physical and mental composite quality of life scores. Patients under hemodialysis with cancer had poor quality of sleep (mean score 8.8 ± 3.5 vs. 6.4 ± 4.1, p = 0.011) and a higher prevalence of restless leg syndrome (55.9 vs. 25.7%, p = 0.011). These features were associated with MIS in patients without cancer but not in patients with cancer.
  
  
  CONCLUSIONS
  Cancer patients undergoing hemodialysis present a higher prevalence of depression, poor quality of life, sleep disorders; however, associations of these features with MIS are different in hemodialysis patients with or without cancer. These findings can change the clinical approach to these patients.
authors.affiliation: Post-Graduation Program in Medical Sciences, Federal University of Ceará, Ceará, Brazil.
authors.forename: Juliana Ramiro Luna
authors.initials: JR
authors.lastname: Castro
authors.forename: Geraldo B
authors.initials: GB
authors.lastname: Silva Junior
authors.forename: André Ferrer
authors.initials: AF
authors.lastname: Carvalho
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Hyphantis
authors.forename: Luiza de Andrade Braga
authors.initials: Lde A
authors.lastname: Farias
authors.forename: Alexandre B
authors.initials: AB
authors.lastname: Libório
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Daher
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D007680:Kidney Neoplasms / Q000150:complications / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D008297:Male; D044342:Malnutrition / Q000503:physiopathology; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D006435:Renal Dialysis; D012148:Restless Legs Syndrome / Q000150:complications / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy; D015431:Weight Loss