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Association of depression with malnutrition in chronic hemodialysis patients.

Abstract

BACKGROUND

Depression is the most common psychological complication and may increase mortality in chronic hemodialysis patients. Because depression could be associated with poor oral intake and activation of proinflammatory cytokines that could further increase mortality by malnutrition, we investigated the relation between depression and nutritional status in chronic hemodialysis patients.

METHODS

Sixty-two Korean patients completed the Beck Depression Inventory (BDI) questionnaire, and the diagnosis of depression was confirmed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for major depressive disorder. Nutritional status was evaluated using serum albumin level, normalized protein catabolic rate, subjective global assessment (SGA), and anthropometric measurement.

RESULTS

Mean BDI score was 22.7 +/- 11.4, and 35 patients (56.5%) had a BDI score greater than 21, which is the suggested cutoff score for the diagnosis of depression for the Korean population. Of 40 patients who had a score higher than 18 on the BDI, 34 patients met DSM-IV criteria for major depressive disorder. BDI score correlated negatively with a variety of nutritional parameters: serum albumin level (r = -0.47; P < 0.001), normalized protein catabolic rate (r = -0.32; P < 0.05), SGA (r = -0.47; P < 0.01), triceps skinfold thickness (r = -0.40; P < 0.05), midarm muscle circumference (r = -0.57; P < 0.01), and body mass index (r = -0.28; P < 0.05). Multiple regression analysis also identified BDI score as an independent determinant for all kinds of nutritional parameters.

CONCLUSION

In patients on chronic hemodialysis therapy, depression is related closely to nutritional status and could be an independent risk factor for malnutrition.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, Division of Nephrology, College of Medicine, Hallym University, Chuchon, Kangwon Do, South Korea. jrkoo@hallym.ac.kr

    , , , , , , , , ,

    Source

    MeSH

    Adult
    Depressive Disorder
    Diabetes Mellitus
    Female
    Humans
    Kidney Failure, Chronic
    Male
    Malnutrition
    Nutritional Status
    Renal Dialysis
    Risk Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12722038

    Citation

    Koo, Ja-Ryong, et al. "Association of Depression With Malnutrition in Chronic Hemodialysis Patients." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 41, no. 5, 2003, pp. 1037-42.
    Koo JR, Yoon JW, Kim SG, et al. Association of depression with malnutrition in chronic hemodialysis patients. Am J Kidney Dis. 2003;41(5):1037-42.
    Koo, J. R., Yoon, J. W., Kim, S. G., Lee, Y. K., Oh, K. H., Kim, G. H., ... Son, B. K. (2003). Association of depression with malnutrition in chronic hemodialysis patients. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 41(5), pp. 1037-42.
    Koo JR, et al. Association of Depression With Malnutrition in Chronic Hemodialysis Patients. Am J Kidney Dis. 2003;41(5):1037-42. PubMed PMID: 12722038.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Association of depression with malnutrition in chronic hemodialysis patients. AU - Koo,Ja-Ryong, AU - Yoon,Jong-Woo, AU - Kim,Seong-Gyun, AU - Lee,Young-Ki, AU - Oh,Kook-Hwan, AU - Kim,Gheun-Ho, AU - Kim,Hyung-Jik, AU - Chae,Dong-Wan, AU - Noh,Jung-Woo, AU - Lee,Sang-Kyu, AU - Son,Bong-Ki, PY - 2003/5/2/pubmed PY - 2004/1/9/medline PY - 2003/5/2/entrez SP - 1037 EP - 42 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am. J. Kidney Dis. VL - 41 IS - 5 N2 - BACKGROUND: Depression is the most common psychological complication and may increase mortality in chronic hemodialysis patients. Because depression could be associated with poor oral intake and activation of proinflammatory cytokines that could further increase mortality by malnutrition, we investigated the relation between depression and nutritional status in chronic hemodialysis patients. METHODS: Sixty-two Korean patients completed the Beck Depression Inventory (BDI) questionnaire, and the diagnosis of depression was confirmed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for major depressive disorder. Nutritional status was evaluated using serum albumin level, normalized protein catabolic rate, subjective global assessment (SGA), and anthropometric measurement. RESULTS: Mean BDI score was 22.7 +/- 11.4, and 35 patients (56.5%) had a BDI score greater than 21, which is the suggested cutoff score for the diagnosis of depression for the Korean population. Of 40 patients who had a score higher than 18 on the BDI, 34 patients met DSM-IV criteria for major depressive disorder. BDI score correlated negatively with a variety of nutritional parameters: serum albumin level (r = -0.47; P < 0.001), normalized protein catabolic rate (r = -0.32; P < 0.05), SGA (r = -0.47; P < 0.01), triceps skinfold thickness (r = -0.40; P < 0.05), midarm muscle circumference (r = -0.57; P < 0.01), and body mass index (r = -0.28; P < 0.05). Multiple regression analysis also identified BDI score as an independent determinant for all kinds of nutritional parameters. CONCLUSION: In patients on chronic hemodialysis therapy, depression is related closely to nutritional status and could be an independent risk factor for malnutrition. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/12722038/Association_of_depression_with_malnutrition_in_chronic_hemodialysis_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272638603002014 DB - PRIME DP - Unbound Medicine ER -