title: Qi deficiency is associated with depression in chronic hemodialysis patients.
abstract: OBJECTIVE
  Depression is a common bio-psycho-social problem in hemodialysis (HD) patients. Traditional Chinese medicine has been used for symptom management in patients with depression. Identification of the specific constitution in traditional Chinese medicine is critical for personalized care. However, the association between depression and specific constitution in HD patients is unknown.
  
  
  METHODS
  We conducted a cross-sectional study in all chronic HD patients (HD for more than 3 months) at China Medical University Hospital in Taiwan. The depression symptom severity was determined using the Beck Depression Inventory II (BDI-II). Clinical patterns in Chinese medicine were determined using the Constitution in Chinese Medicine Questionnaire. The association between constitution and depression was analyzed using logistic regression.
  
  
  RESULTS
  We recruited 467 chronic hemodialysis patients, including 219 females and 248 males, with a mean age of 63±12years. The mean duration of HD was 5.8 years. The mean score for the BDI-II was 11 (interquartile range 8-14). The major constitution was Yang-deficiency (43.7%) among these chronic HD patients. Qi-deficiency was correlated with a duration of HD of more than 5.8 years (p=0.04). Qi-deficiency [odds ratio (OR): 4.05, 95% confidence interval (CI): 1.69-9.72, p<0.01] was also associated with depression in logistic regression with adjustments for confounders, including calcium, phosphorus and hemoglobin levels.
  
  
  CONCLUSIONS
  Qi-deficiency constitution in Chinese medicine is associated with depression in chronic HD patients. Further studies are needed to determine whether treating Qi-deficiency integrating Chinese medicine treatment can improve patients' depression symptoms.
authors.affiliation: Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan.
authors.forename: Yuan-Ching
authors.initials: YC
authors.lastname: Liao
authors.affiliation: Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung 404, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan.
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Chou
authors.affiliation: Kidney Institute and Division of Nephrology, China Medical University Hospital, Taichung 404, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan.
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
authors.affiliation: Graduate Institute of Biostatistics, China Medical University, Taichung, 404, Taiwan.
authors.forename: Tsai-Chung
authors.initials: TC
authors.lastname: Li
authors.affiliation: Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan.
authors.forename: Mao-Feng
authors.initials: MF
authors.lastname: Sun
authors.affiliation: Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan.
authors.forename: Hen-Hong
authors.initials: HH
authors.lastname: Chang
authors.affiliation: School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, 404, Taiwan.
authors.forename: Fuu-Jen
authors.initials: FJ
authors.lastname: Tsai
authors.affiliation: Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 404, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, 404, Taiwan; Research Center for Traditional Chinese Medicine, Department of Medical Research and Department of Chinese Medicine, China Medical University Hospital, Taichung 404, Taiwan. Electronic address: hungrongyen@gmail.com.
authors.forename: Hung-Rong
authors.initials: HR
authors.lastname: Yen
mesh_terms: D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology* / Q000503:physiopathology*; D003866:Depressive Disorder / Q000209:etiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods; D008875:Middle Aged; D019413:Qi; D006435:Renal Dialysis / Q000009:adverse effects*; D013624:Taiwan
keywords: Chronic kidney diseases; Constitution; Depression; Hemodialysis; Traditional Chinese medicine