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

ABSTRACT

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.