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Association between depression and malnutrition–inflammation complex syndrome in patients with continuous ambulatory peritoneal dialysis

  • Nephrology – Original Paper
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Abstract

Objective

Depression, the most common psychological disorder among patients with end-stage renal disease (ESRD), is associated with poor survival. The prevalence of depression and its relation with the malnutrition–inflammation complex syndrome (MICS) have not yet been clearly defined in Chinese continuous ambulatory peritoneal dialysis (CAPD) patients.

Patients and methods

A total of 142 patients on CAPD were enrolled in the First Affiliated Hospital of Sun Yat-Sen University. The Hamilton Depression Scale (HAMD) and the malnutrition–inflammation score (MIS) were used for depression and MICS evaluation, respectively. Clinical, socioeconomic, and malnutrition–inflammation factors were compared among patients with and without depression. Binary regression analysis was performed to investigate the independent association between depression and MICS.

Results

The mean HAMD and MIS scores were 7.12 ± 5.28 and 4.45 ± 3.56, respectively. According to HAMD, 37 patients (26.1%) had depression and 70 patients (49.3%) had potential depression. Older age, longer dialysis vintage, worse residual renal function, lower employment and reimbursement status, and higher comorbidity index were positively correlated with depression. Compared to non-depressed patients, the depressed ones also showed lower levels of serum albumin and higher levels of C-reactive protein (CRP). Correlation results showed that the HAMD scores were significantly and positively correlated with MIS (r = 0.46, P < 0.01). Moreover, the incidence of peritonitis was significantly higher in depressed compared to non-depressed patients. Binary regression analysis showed that MIS was the only independent risk factor for depression.

Conclusion

Depression is commonly encountered in Chinese CAPD patients. A close relationship exists between depression and MICS.

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Authors and Affiliations

  1. Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, 58th Zhongshan 2nd Road, Guangzhou, 510080, People’s Republic of China

    Zhi-Jian Li, Hai-Ping Mao, Xin Wei, Jie-Hui Chen, Xiao Yang & Xue-Qing Yu

  2. Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, People’s Republic of China

    Xin An

  3. School of Health Sciences, RMIT University, Bundoora, VIC, 3083, Australia

    Shu-Feng Zhou

  4. Epidemiology and Clinical Research Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China

    Zhi-Bin Li

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  1. Zhi-Jian Li
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  2. Xin An
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  4. Xin Wei
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Corresponding author

Correspondence to Xue-Qing Yu.

Additional information

The authors Zhi-Jian Li and Xin An contributed equally to this work.

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Li, ZJ., An, X., Mao, HP. et al. Association between depression and malnutrition–inflammation complex syndrome in patients with continuous ambulatory peritoneal dialysis. Int Urol Nephrol 43, 875–882 (2011). https://doi.org/10.1007/s11255-011-9917-x

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  • DOI: https://doi.org/10.1007/s11255-011-9917-x

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