ABSTRACT
Health-related quality of life (QOL) and depression burden of Mexican Americans with end-stage renal disease (ESRD) are not known. This observational cross-sectional study assessed QOL and depression and examined their inter-relatedness in Mexican Americans with type 2 diabetes and ESRD on maintenance hemodialysis (HD) treatment. Prevalent Mexican Americans on HD (N = 40) completed the Kidney Disease Quality of Life-Short Form (KDQOL-SF) and the Beck Depression Inventory II. The overall median scores for the mental component summary and the physical component summary scales in the KDQOL-SF were 40.9 and 34.0, respectively. The prevalence of severe depression was 40%. The most significant differences between depressed and non-depressed groups were symptom/problem list, cognitive function, and emotional well- being (P < 0.0001 for all). Mexican Americans with depression endure a more dismal QOL compared to non-depressed peers. Significant negative correlations between depression and several QOL scales underscore plausible interactions between the two conditions which warrants further evaluation.
Subject(s)
Depressive Disorder/complications , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/psychology , Mexican Americans/psychology , Quality of Life/psychology , Renal Dialysis/psychology , Cross-Sectional Studies , Depressive Disorder/psychology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/psychology , Humans , Kidney Failure, Chronic/therapy , Male , Mexican Americans/statistics & numerical data , Middle Aged , Psychiatric Status Rating Scales , Surveys and QuestionnairesABSTRACT
BACKGROUND/AIM: Toll-like receptor 4 (TLR4) is one of the regulators of the innate immune response. Genetic variations in TLR4 have been associated with inflammatory diseases, including type 2 diabetes. However, to our knowledge, there are no reports on the role of variations in TLR4 in chronic kidney disease susceptibility. The objective of this study is to determine whether the genetic variants in TLR4 are associated with the estimated glomerular filtration rate (eGFR), a measure of renal function. METHODS: To evaluate the association between TLR4 variants and eGFR, we used data obtained from 434 Mexican American participants from the San Antonio Family Diabetes/Gallbladder Study. GFR was estimated using the Modification of Diet in Renal Disease formula. The Asp(299)Gly (rs4986790) and Thr(399)Ile (rs4986791) variants of TLR4 were genotyped using the TaqMan assay. Association analyses between genotypes and eGFR were performed using the measured genotype approach. RESULTS: Of the two genetic markers examined for association, only the Asp(299)Gly variant of TLR4 exhibited a nominally significant association with eGFR (p = 0.025) after accounting for the covariate effects of age and sex terms, diabetes, duration of diabetes, systolic blood pressure, body mass index, and antihypertensive treatment. Carriers of Gly299 had significantly decreased eGFR values. Although, the Thr(399)Ile variant failed to exhibit a statistically significant association with eGFR, the carriers of Ile399, however, showed a trend towards decrease in eGFR. CONCLUSION: We show for the first time that Asp(299)Gly variants of TLR4 are associated with decrease in renal function in Mexican Americans.