Depression, quality of life and malnutrition-inflammation scores in hemodialysis patients
Depression, quality of life and malnutrition-inflammation scores in hemodialysis patients
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DOI：
10.1159/000131101
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发表时间：
2008-01-01
影响因子：
4.2
通讯作者：
El Salamony, Omima
中科院分区：
文献类型：
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作者：
Ibrahim, Salwa;El Salamony, Omima
背景资料：抑郁症是终末期肾病（ESRD）患者中最常见的精神疾病，与相当大比例患者的死亡、心血管事件和住院风险增加相关。据报道，透析患者的生活质量（QoL）受损，是不良结局的标志。我们的目的是评估慢性血液透析患者抑郁的患病率和生活质量状况。我们探讨了抑郁症状和生活质量差之间的关系，一方面和社会人口学特征，透析充分性，血清化学，营养不良炎症评分（MIS）和症状负担。患者和方法：2007年6月至8月，60例慢性血液透析患者参加了研究。他们在开罗大学医院的Kasr El-Aini肾病和透析中心接受每周三次的透析。获得临床和社会人口学数据，并审查其病例记录，以获得实验室结果，包括血红蛋白、尿素还原率、血清白蛋白、钙、磷、肌酐和总铁结合力。我们使用贝克抑郁量表（BDI）评估抑郁的严重程度，SF-36问卷评估研究组的生活质量。MIS用于评估营养不良和炎症复合物的程度，并使用透析症状指数（DSI）评估总症状负担。结果：平均年龄为46.13 ± 16.55岁，范围为22-77岁。20例患者（33.33%）的BDI评分>= 15。2例患者（3.33%）的QoL总分< 50，8例患者（13.33%）的QoL总分在50-60之间，30例患者（50%）的QoL总分在60-70之间，12例患者（20%）的QoL总分在70-80之间，8例患者（13.3%）的QoL总分在80-90之间。就业显着影响BDI分数，所有患者的BDI分数6 - 15失业。失业患者的平均BDI评分显著高于就业患者（13.03 +/- 6.27 vs. 8.50 +/- 3.51，p = 0.03）。丧偶患者的BDI显著高于单身、已婚和离异患者，F-36评分显著低于单身、已婚和离异患者（p < 0.05）。DSI和MIS与BDI评分呈显著正相关（p < 0.05），与F-36评分呈显著负相关（p < 0.05）。结论：我们的研究结果显示，研究组中抑郁症状的患病率很高，与生活质量差、总症状负担和营养不良-炎症复合体有关。版权所有（C）2008 S. Karger AG，巴塞尔。
Background: Depression is the most common psychiatric illness in patients with end-stage renal disease (ESRD), and has been associated with increased risk of death, cardiovascular events and hospitalization in a substantial proportion of patients. Impaired quality of life (QoL) has been reported in dialysis patients and is a marker of poor outcome. We aimed to assess the prevalence of depression and QoL status among chronic hemodialysis patients. We explored the relationship between depressive symptoms and poor QoL on the one hand and sociodemographic profile, dialysis adequacy, serum chemistry, malnutrition-inflammation score (MIS) and symptom burden on the other hand. Patients and Methods: 60 chronic hemodialysis patients participated in the study between June and August 2007. They were on thrice-weekly dialysis at the Kasr El-Aini Nephrology and Dialysis Center, Cairo University Hospital. Clinical and sociodemographic data were obtained and their case records were reviewed to obtain laboratory results including hemoglobin, urea reduction ratio, serum albumin, calcium, phosphorus, creatinine and total iron-binding capacity. We used the Beck Depression Inventory (BDI) to assess the severity of depression, and the SF-36 questionnaire to assess QoL in the study group. MIS was used to assess the extent of malnutrition and inflammation complex and total symptom burden was evaluated using the dialysis symptom index (DSI). Results: Mean age was 46.13 +/- 16.55 years, with a range of 22-77 years. 20 patients (33.33%) had a BDI score of >= 15. Two patients (3.33%) had a QoL total score of < 50, 8 (13.33%) had scores in the range of 50-60, 30 (50%) had scores in the range of 60-70, 12 (20%) had scores of 70-80, and 8 patients (13.3%) had scores in the range of 80-90. Employment was found to significantly affect BDI scores; all patients with BDI scores 6 15 were unemployed. The mean BDI score of unemployed patients was significantly higher than employed patients (13.03 +/- 6.27 vs. 8.50 +/- 3.51, p = 0.03). Widowed patients had significantly higher BDI and lower F-36 scores compared to single, married and divorced patients (p < 0.05). DSI and MIS showed significant positive correlations with BDI scores (p < 0.05) and significant negative correlations with F-36 scores (p < 0.05). Conclusions: Our results showed a high prevalence of depressive symptoms among the study group that was linked to poor QoL, total symptom burden and malnutrition-inflammation complex. Copyright (C) 2008 S. Karger AG, Basel.