Study of the relationship between inflammation and depression in haemodialysis patients

Abstract

Chronic kidney disease (CKD) is determined by the presence of kidney injury and by the level of renal function, assessment according to the glomerular filtration rate. The medical risk factors associated with increased mortality in hemodialysis (HD) patients are well known, but the psychosocial factors that may affect outcome have not been clearly defined. One key psychosocial factor, depression, has been considered a predictor of mortality. Depression is the most common psychiatric illness in patient with CKD affecting 20-30% patients on dialysis with 10 % having major depressive disorders. Depression in patients with CKD is multifactorial, both medically and psychologically based. Additional factors also influence development of depression in ESRD patients. Depression is a new player in MIA syndrome. Depressive symptoms are frequent in our study patients (61.4 %) with BDI scores cutoff > 16. There are positive correlations between presence of depressive symptoms and time spent in hospitals during the last year, duration of hemodialysis sessions , and decreased HB level. According to age, sex and marital state, in our study we did not find any effect of age, nor difference between male and female, also there is no influencement of marital state on appearance of depressive symptoms. The effect of depression is independent of the causes in ESRD(like, hypertension, .diabetes , ,GN ,SLE, stones , etc. ) , and co morbidity associated (like COPD,DM,HTN,) except in patients with ischemic heart disease and CVS disease. High sensitive C-reactive protein (HS-CRP) concentration was used to predict outcome in hemodialysis patients, we found increasing in his (HS-CRP) in patients with depressive symptoms ,and also increase in BDI scores , that means there is close correlation between inflammation and depression in dialysis patients. Depression has potentially been linked to inflammation in ESRD patients.