The relationship between depression-malnutrition and echocardiographic-blood pressure parameters in chronic hemodialysis patients.

AIMS

The aim is to research the relationship between the degree of depression-malnutrition and inadequate volume control.

METHODS

The mean age of the 52 patients was 55+/-14.6 years. Malnutrition score [subjective global assessment (SGA)] and depression score [Taiwanese Depression Questionnaire (TDQ)] of each chronic hemodialysis (CHD) patient were calculated. Then an echocardiographic assessment was carried out with the same device 1 day before the second HD session of the week. The 24 h blood pressure monitoring was performed 1 day before the second HD session of the week.

RESULTS

TDQ scores (TDQS) were >or=19 in 41 and <19 in 11 patients. TDQS was found to be significantly high in women (p=0.01) who were older than 40 years (p=0.03) and who have low family income (p=0.03). TDQS was found to be significantly correlated with HD duration (p=0.034), vena cava inferior collapse index (p=0.02), malnutrition score (p=0.011), residual renal function (ml/day) (p=0.03), level of albumin (p=0.0009), and iron (p=0.015). A positive correlation was detected between TDQS and the ratio of mean nighttime blood pressure/mean daytime blood pressure (p=0.005, r=0.394). Depression score was found to be significantly different between normal geometry and left ventricular hypertrophy (eLVH), concentric remodeling and eLVH, and concentric LVH and eLVH.

CONCLUSIONS

The results show that lesser degrees of nocturnal dip and eLVH are associated with increased degrees of depression, implying that hypervolemia is strongly associated with depression and might be a component of strong relationships involving malnutrition, inflammation, and atherosclerosis in CHD patients.