Stanisławska Martyna, Roman Maja, Nowicki Michał
Department of Nephrology, Hypertension and Kidney Transplantation, Central University Hospital, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland.
Biomedicines. 2024 Jan 4;12(1):103. doi: 10.3390/biomedicines12010103.
Depression is highly prevalent among hemodialysis patients. Understanding the relationship between the plasma neurofilament light chain (NfL) and brain-derived neurotrophic factor (BDNF) may help us to better understand the mechanisms of depression. This study determined their impact, alongside that of other factors, on the risk of depression in hemodialysis patients.
The study enrolled 82 patients undergoing chronic hemodialysis. Serum NfL, BDNF, uric acid, urea, potassium, calcium, phosphorus, intact parathyroid hormone, and C-reactive protein (CRP) levels were measured. The patients completed the Beck Depression Inventory (BDI). Blood pressure values, body mass before and after hemodialysis, and weekly duration of hemodialysis in hours were assessed. For 19-month survival analysis, the patients were stratified according to baseline BDI scores.
Based on the BDI score, 18.3% of the patients had an increased risk of depression. Lower scores were associated with significantly longer duration of hemodialysis treatment (37.5 (25-57) 24 (14-37) months, = 0.01). Within the 19-month survival analysis, 31.7% of patients died. The patients with BDI scores above the median had significantly lower survival than those below the median (log-rank test = 0.02). No significant differences in serum BDNF levels (192.7 [125.2-278.2]; 207.7 [142.8-265.8] pg/mL, = 0.40), or NfL concentrations (1431.5 [1182.6-1625.7]; 1494.6 [1335.7-1667] kDa, = 0.52) were found between patients with lower and higher risk of depression. Patients with BDI scores above the median had significantly higher levels of CRP (9.6 [4.4-14]) than those with scores below the median (3.6 [2.2-7.5], = 0.01). A significant positive correlation was found between the BDI score and serum CRP level (r = 0.38, = 0.01). A significant negative correlation was observed between the BDI score and URR% value (r = -0.36, = 0.02).
Patients with lower BDI scores had a longer dialysis duration, indicating a potential negative association between depression risk and length of dialysis treatment. Neither serum NfL nor BDNF levels can serve as markers of depression risk in the dialysis population.
抑郁症在血液透析患者中极为普遍。了解血浆神经丝轻链（NfL）与脑源性神经营养因子（BDNF）之间的关系可能有助于我们更好地理解抑郁症的发病机制。本研究确定了它们以及其他因素对血液透析患者发生抑郁症风险的影响。
该研究纳入了82例接受慢性血液透析的患者。测量了血清NfL、BDNF、尿酸、尿素、钾、钙、磷、完整甲状旁腺激素和C反应蛋白（CRP）水平。患者完成了贝克抑郁量表（BDI）。评估了血压值、血液透析前后的体重以及每周血液透析的时长（以小时为单位）。对于19个月的生存分析，根据基线BDI评分对患者进行分层。
根据BDI评分，18.3%的患者有患抑郁症的风险增加。得分较低与血液透析治疗时间显著延长相关（37.5（25 - 57）对比24（14 - 37）个月，P = 0.01）。在19个月的生存分析中，31.7%的患者死亡。BDI评分高于中位数的患者的生存率显著低于中位数以下的患者（对数秩检验P = 0.02）。抑郁症风险较低和较高的患者之间，血清BDNF水平（192.7 [125.2 - 278.2]；207.7 [142.8 - 265.8] pg/mL，P = 0.40）或NfL浓度（1431.5 [1182.6 - 1625.7]；1494.6 [1335.7 - 1667] kDa，P = 0.52）均未发现显著差异。BDI评分高于中位数的患者的CRP水平（9.6 [4.4 - 14]）显著高于评分低于中位数的患者（3.6 [2.2 - 7.5]，P = 0.01）。BDI评分与血清CRP水平之间存在显著正相关（r = 0.38，P = 0.01）。BDI评分与URR%值之间存在显著负相关（r = -0.36，P = 0.02）。
BDI评分较低的患者透析时间更长，表明抑郁症风险与透析治疗时长之间可能存在负相关。血清NfL和BDNF水平均不能作为透析人群抑郁症风险的标志物。
