Relation Between Depression, Some Laboratory Parameters, and Quality of Life in Hemodialysis Patients

Abstract

Depression is common in patients with end-stage renal disease (ESRD) and is associated with increased mortality and morbidity. Several investigators have estimated that depression occurs in about 20% to 30% of dialysis patients. The aim of this study was to investigate the relationship between depression, some laboratory parameters, and quality of life (QOL) in hemodialysis patients. Forty-three hemodialysis patients (mean age 40.5 +/- 15.2; M = 28, F = 15) were included in the study. Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and short form with 36 (SF-36) were used for evaluation. Subsequently, patients were divided into two groups according to HAMD scores: group 1, those who had a low HAMD score (between 0 and 7), and group 2, those who had a high HAMD score (over 7). The two groups were compared in terms of anxiety scores, QOL scores, and some laboratory parameters. The group 2 patients (n = 21; M = 13, F = 8) had lower levels of hemoglobin than the group 1 patients (9.5 +/- 1.7 vs. 10.7 +/- 1.4 g/dL, respectively; p < 0.01). Group 2 patients also had lower SF-36 scores than group 1 patients (91.5 +/- 21.3 vs. 74.9 +/- 13.6, respectively; p = 0.03). On the contrary, the patients of group 2 had higher HAMA scores than group 1 patients (16.6 +/- 6.9 vs. 6.3 +/- 3.5, respectively; p < 0.01) and CRP level (10.7 +/- 4.6 vs. 4.5 +/- 3.8, respectively; p < 0.001). A significant correlation was found between depression scores and C-reactive protein (CRP) (r = 0.57, p < 0.001) and HAMA scores (r = -0.43, p < 0.05). In contrast, a negative correlation was found between HAMD scores and albumin (r = -0.43, p< 0.05), hemoglobin (r = -0.38, p = 0.015) and SF-36 scores (r = 0.39, p = 0.032). These findings demonstrate that there is a relationship among high depression score, low levels of hemoglobin and albumin, high CRP level, low SF-36 score, and high anxiety score. Evaluation of psychiatric status should be part of the care provided to hemodialysis patients.