Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, 58th Zhongshan 2nd Road, Guangzhou 510080, People's Republic of China.
Int Urol Nephrol. 2011 Sep;43(3):875-82. doi: 10.1007/s11255-011-9917-x. Epub 2011 Mar 2.
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.
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.
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.
Depression is commonly encountered in Chinese CAPD patients. A close relationship exists between depression and MICS.
抑郁症是终末期肾病（ESRD）患者中最常见的心理障碍，与生存率降低有关。抑郁症的患病率及其与营养不良-炎症综合征（MICS）的关系尚未在我国持续不卧床腹膜透析（CAPD）患者中明确界定。
中山大学附属第一医院共纳入 142 名 CAPD 患者。采用汉密尔顿抑郁量表（HAMD）和营养不良-炎症评分（MIS）评估抑郁和 MICS。比较有和无抑郁患者的临床、社会经济和营养不良-炎症因素。采用二元回归分析探讨抑郁与 MICS 的独立相关性。
平均 HAMD 和 MIS 评分为 7.12±5.28 和 4.45±3.56。根据 HAMD，37 名患者（26.1%）患有抑郁症，70 名患者（49.3%）有潜在抑郁。年龄较大、透析时间较长、残余肾功能较差、就业和报销状况较差以及合并症指数较高与抑郁呈正相关。与非抑郁患者相比，抑郁患者的血清白蛋白水平较低，C 反应蛋白（CRP）水平较高。相关性结果表明，HAMD 评分与 MIS 呈显著正相关（r=0.46，P<0.01）。此外，与非抑郁患者相比，抑郁患者腹膜炎的发生率显著更高。二元回归分析表明，MIS 是抑郁的唯一独立危险因素。
抑郁症在我国 CAPD 患者中较为常见。抑郁与 MICS 之间存在密切关系。
