Department of Nephrology, Endocrinology and Metabolic Disorders, Medical University of Silesia, Francuska 20-24, 40-027, Katowice, Poland.
Int Urol Nephrol. 2013 Aug;45(4):1121-8. doi: 10.1007/s11255-012-0269-y. Epub 2012 Sep 13.
Prevalence of depression is high in patients with chronic kidney disease. Depression is associated with increased mortality and the higher rate of suicides in these patients. The aim of the study was to estimate the prevalence of depressive symptoms in haemodialyzed patients in Upper Silesia region of Poland and the possible role of inflammation in depression development.
Six hundred and ninety-seven haemodialyzed patients from 22 dialysis centres in Upper Silesia region of Poland were enrolled into the study. Mean age was 59.1 ± 0.5 years, and mean time of dialysis treatment was 3.6 ± 0.2 years. Each patient received 21-item Beck Depression Inventory (BDI) questionnaire for depression screening. Additional questions considering length of dialysis treatment, concomitant diseases and number of days spent in hospitals during the last year were also asked.
Depressive symptoms were found in 268 (38.6 %) patients. Patients with depressive symptoms when compared with the patients without them tended to have higher C-reactive protein plasma concentration (14.3 ± 1.3 vs. 11.1 ± 0.9 mg/l; p = 0.067) and were more often dialyzed with central catheter (27.6 vs. 18.2 %; p = 0.0042). During the last year, patients with depressive symptoms spent in hospitals more days than patients without depressive symptoms (24.3 vs. 15.3 days, respectively; p < 0.0001). Significant positive correlation between BDI score and C-reactive protein level (r = 0.1625; p = 0.001) was found both in univariate and multivariate analysis.
(1) Depressive symptoms are frequently found (38.6 %) in haemodialyzed patients in Upper Silesia part of Poland. (2) Catheter placement and inflammation seem to play an important role in the pathogenesis of depression in haemodialysis patients.
慢性肾脏病患者的抑郁患病率很高。抑郁与这些患者的死亡率增加和更高的自杀率有关。本研究的目的是评估波兰上西里西亚地区血液透析患者抑郁症状的患病率，以及炎症在抑郁发展中的可能作用。
纳入了来自波兰上西里西亚地区 22 个透析中心的 697 名血液透析患者。平均年龄为 59.1±0.5 岁，透析治疗时间平均为 3.6±0.2 年。每位患者均接受 21 项贝克抑郁量表（BDI）问卷进行抑郁筛查。还询问了与透析治疗时间、并存疾病以及过去一年住院天数相关的其他问题。
发现 268 名（38.6%）患者存在抑郁症状。与无抑郁症状的患者相比，有抑郁症状的患者 C 反应蛋白血浆浓度更高（14.3±1.3 比 11.1±0.9 mg/L；p=0.067），且更常使用中心导管进行透析（27.6%比 18.2%；p=0.0042）。在过去一年中，有抑郁症状的患者住院天数多于无抑郁症状的患者（分别为 24.3 比 15.3 天；p<0.0001）。在单变量和多变量分析中均发现 BDI 评分与 C 反应蛋白水平之间存在显著正相关（r=0.1625；p=0.001）。
（1）在波兰上西里西亚地区的血液透析患者中，抑郁症状经常出现（38.6%）。（2）导管放置和炎症似乎在血液透析患者抑郁发病机制中起重要作用。
