Depression in dialysis patients and its association with nutritional markers and quality of life

Abstract

Background: Depression is the most widely prevalent psychiatric disorder in dialysis and can result in a lower quality of life (QoL) and probably a worse nutritional status. The aim of this study was to evaluate the associations among depression, QoL and nutritional status in hemodialysis.

Methods: This study included 104 patients on dialysis longer than 3 months, aged 18-65 years. Their nutritional status was assessed according to body mass index (BMI), serum albumin and phase angle; QoL was assessed using the SF-36 questionnaire, and their risk of depression was measured using the Beck Depression Inventory (BDI). Associations among depression, QoL and nutritional status were assessed using Fisher's exact test, and correlations between continuous variables were examined by Pearson's coefficient.

Results: Depression was detected in 65.3% of patients, and all of the dimensions of QoL were compromised, with the worst values observed for role-functioning physical (RP) and general health (GH). A negative correlation between the dimensions of QoL and BDI score was observed. Serum albumin was significantly correlated with general health (GH), and phase angle with physical functioning (PF).

Conclusion: A high prevalence of depression was detected, as well as reduced mean scores for QoL. BDI score was significantly correlated with both physical and mental components of QoL. Phase angle was associated with physical functioning (PF) and physical component summary scales (PCS), whereas no nutritional marker was associated with the BDI score. The periodic monitoring of depression should be implemented in hemodialysis, in addition to monitoring QoL and nutritional status. A better understanding of these relationships could result in a better efficiency of dialysis treatment.