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. 2017 Jan 12;5(1):1.
doi: 10.1186/s40359-016-0170-z.

Kidney dysfunction, systemic inflammation and mental well-being in elderly post-myocardial infarction patients

Rick H M Heeres  1 , Ellen K Hoogeveen  2 , Johanna M Geleijnse  3 , Janette de Goede  3 , Daan Kromhout  3 , Erik J Giltay  4
Affiliations

Kidney dysfunction, systemic inflammation and mental well-being in elderly post-myocardial infarction patients

Rick H M Heeres et al. BMC Psychol. .

Abstract

Background: The aim was to investigate whether mild kidney dysfunction and low-grade inflammation in post-myocardial infarction patients are independently associated with markers of mental well-being (i.e. depressive and apathy symptoms, and dispositional optimism).

Methods: In post-myocardial infarction patients, kidney function was assessed by estimated glomerular filtration rate (eGFR) calculated from the combined CKD-EPI formula based on serum levels of both creatinine and cystatine C. Systemic inflammation was assessed using high sensitivity C-reactive protein (hs-CRP) levels. The 15-item Geriatric Depression Scale (GDS-15), the 3-item apathy subscale and the 4-item optimism questionnaire (4Q) were used to measure mental well-being and were analyzed using linear multivariable regression analysis.

Results: Of the 2355 patients, mean age was 72.3 (range 63-84) years and 80.1% were men. After multivariable adjustment, a poorer kidney function was associated with more depressive symptoms (β = -0.084, p < 0.001), more apathy symptoms (β = -0.101, p < 0.001), and less dispositional optimism (β = 0.072, p = 0.002). Moreover, higher levels of hs-CRP were associated with more depressive symptoms (β = 0.051, p = 0.013), more apathy symptoms (β = 0.083, p < 0.001) and less dispositional optimism (β = -0.047 p = 0.024). Apathy showed the strongest independent relation with both low eGFR and high hs-CRP.

Conclusions: In post-myocardial infarction patients, impaired kidney function and systemic inflammation showed a stronger association with apathy than with depressive symptoms and dispositional optimism.

Keywords: Apathy; Depressive symptoms; Dispositional optimism; Kidney dysfunction; Myocardial infarction; Systemic inflammation.

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Figures

Fig. 1
Fig. 1
Associations of the creatinine-cystatin C-based eGFR and serum CRP levels with apathy in 2355 post-myocardial infarction patients. Mean serum eGFR and CRP levels are shown with error bars representing standard errors (SE), adjusted for age, sex, education, body mass index, smoking status, alcohol use, antidepressant use, statin use, time since myocardial infarction, stroke, and diabetes. The box sizes represent the relative number of patients
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