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The association of depression with malnutrition, inflammation and cardiovascular disease in peritoneal dialysis patients
2014, 13 (02):
77-81.
doi: 10.3969/j.issn.1671-4091.2014.02.004
Objective The objective of this study was to explore the association of depression with inflammation, malnutrition and cardiovascular disease in peritoneal dialysis (PD) patients. Methods One hundred and twenty patients undergoing peritoneal dialysis over three months were enrolled in this study. We used the Zung self-rating depression scale (SDS) to assess the severity of depression, and the SF-36 questionnaire to assess quality of life. Clinical data, cardiovascular disease, and laboratory results were collected. Patients were divided into groups based on cardiovascular events and the values of Alb (<35g/L) and CRP (＞ 8mg/L) Results ① In peritoneal dialysis patients, the prevalence of depression (SDS score ≥50) was 55.83%. The prevalence of depression was higher in females (44 cases, 65.67%) than in males (23 cases, 34.33%), and was higher in the PD patients with longer dialysis age (average 28 months, 17～60 months), lower serum albumin (33.78±4.03 g/L), lower hemoglobin (102.60±15.18 g/L), less residual renal function (average 0.78 ml/ min, 0.00～2.53 ml/min), higher serum CRP (average 2.7 mg/L, 2.1～8.0 mg/L), and higher rate of cardiovascular event (29.85%), than in those with higher serum albumin (36.48±2.84)g/L), higher hemoglobin (112.26± 10.07 g/L), more residual renal function (average 1.25 ml/min, 0.00～1.50 ml/min), lower serum CRP (average 2.4 mg/L, 1.85～3.20 mg/L), and lower rate of cardiovascular event (9.43%). These parameters were statistically significant (P＜0.05) between PD patients with depression and those without depression. In PD patients with depression, the scores of quality of life were lower in every dimension than in those without depression (P=0.002).②Binary logistic regression analysis demonstrated that depression was significantly correlated with residual renal function (B=-0.434, OR=0.648, P=0.045) and assignment of group (P=0.008). (c) Multivariate linear regression analyses showed that residual renal function (B=1.975, P=0.009), gender (B=6.955, P=0.003), and assignment of group (B=- 3.669, P=0.009) were the independent risk factors for quality of life. Conclusion The prevalence of depression was higher in PD patients, especially in those with Alb ≤35g/L, CRP ≥8mg/L, and cardiovascular diseases.
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