Plasma brain-derived neurotrophic factor before hemodialysis reduces the risk of depression in patients with chronic renal failure.

BACKGROUND

Neurotrophins are related with depressive disorders. Significant neurotrophins variations occur during renal replacement therapy, but whether peri-hemodialysis availability is associated with depression in patients with Chronic Kidney Disease (CKD) is yet unclear.

AIM

To determine dynamic concentrations of neurotrophins in the peri-hemodialysis range and their association with depressive symptoms in patients with CKD.

METHODS

Pre-, and post-hemodialysis plasma concentrations of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF), as well as their plasma clearance rates, were determined (multiplexing) in patients with stage 5 CKD. Depressive symptoms, as assessed by the Beck Depression Inventory-II (BDI-II), were determined. Finally, the bioavailability of BDNF and NGF was related to the score of depressive symptoms.

RESULTS

Fifty-three patients were divided according to depressive symptoms. Pre-hemodialysis plasma BDNF was lower in patients with depressive disorder; whereas basal BDNF value >220 pg/mL independently reduced the risk for depressive disorder (Odds Ratio 0.23,  = 0.047) at uni- and multivariate analysis. Post-hemodialysis concentration and clearance rate of neurotrophins were not related with depressive symptoms.

CONCLUSION

Higher plasma BDNF before hemodialysis reduces the risk of mild depression in patients with CKD under renal replacement therapy.