The Relationship of Serum Cortisol Levels with Depression, Cognitive Function and Sleep Disorders in Chronic Kidney Disease and Hemodialysis Patients
The Relationship of Serum Cortisol Levels with Depression, Cognitive Function and Sleep Disorders in Chronic Kidney Disease and Hemodialysis Patients
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DOI：
10.1007/s11126-014-9307-5
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发表时间：
2014-12-01
影响因子：
3.5
通讯作者：
Afsar, Baris
中科院分区：
文献类型：
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作者：
Afsar, Baris
本研究探讨慢性肾脏病(CKD)和血液透析(HD)患者的皮质醇、认知功能、抑郁行为和睡眠质量之间的关系。患者接受病史采集、体格检查、生化分析、24小时尿液采集(仅适用于CKD患者)、透析充分性测定(仅适用于HD患者)、认知功能、抑郁行为和睡眠质量的评估。在研究对象中，肌酐清除量为万分之60毫升/分钟/1.73米(2)者58人(组1)，肌酐清除量30~59毫升/分钟/1.73米(2)者41人(2组)，肌酐清除量15~29毫升/分钟/1.73米(2组)25人(3组)，肌酐清除量15毫升/分钟/1.73米(2组)12人(4组)。38例为常规血液透析患者(第5组)。第1、2、3、4、5组皮质醇水平分别为472.3+/-A 138.4、490.2+/-A 214.3、541.6+/-A 172.8、569.9+/-A 101.0和637.8+/-A 153.7 nmol/L(趋势P<；0.0001)。线性回归分析显示，非透析组和透析组皮质醇水平与Beck抑郁量表评分独立相关(P分别为0.013和0.001)，而与认知功能和睡眠质量无关。总之，血清皮质醇水平与CKD和HD患者的抑郁行为独立相关，但与认知功能和睡眠质量无关。
In the present study, the relationships between cortisol, cognitive function, depressive behavior, and sleep quality in chronic kidney disease (CKD) and hemodialysis (HD) patients was investigated. Patients underwent history taking, physical examination, biochemical analysis, 24-h urine collection (for CKD patients only), measurement of dialysis adequacy (for HD patients only), evaluation of cognitive function, depressive behavior and sleep quality. Among study participants 58 had creatinine clearance a parts per thousand yen60 mL/min/1.73 m(2) (Group 1), 41 had creatinine clearance between 30 and 59 mL/min/1.73 m(2) (Group 2), 25 had creatinine clearance between 15 and 29 mL/min/1.73 m(2) (Group 3) and 12 had creatinine clearance < 15 mL/min/1.73 m(2) (Group 4). 38 patients were regular HD patients (Group 5). The cortisol levels in Group 1, 2, 3, 4 and 5 patients were 472.3 +/- A 138.4, 490.2 +/- A 214.3, 541.6 +/- A 172.8, 569.9 +/- A 101.0 and 637.8 +/- A 153.7 nmol/L, respectively (P < 0.0001 for trend). In both non-dialysis patient group and dialysis patients linear regression analysis showed that cortisol was independently related with Beck depression inventory (BDI) score (P: 0.013 and 0.001, respectively) but not with cognitive function and sleep quality. In conclusion serum cortisol levels were independently associated with depressive behavior both in CKD and HD patients but not with cognitive function and sleep quality.