Depression, Inflammation, and Social Support in Hemodialysis Patients

Abstract

Aim: Depression and inflammation are common in patients with end-stage renal disease (ESRD). In our study, we aimed to investigate the relationship between depression, inflammation and social support. Material and Method: Accordingly. 137 patients were enrolled. We used Beck Depression Inventory (BDI) and Multidimensional Scale of Perceived Social Support (MSPSS) and Malnutrition Inflammation Score (MIS) in all patients. Results: BDI, MSPSS and MISS were 15.9 +/- 9.5,60.5 +/- 15.1,7.8 +/- 2.9 respectively. The patients were divided into two groups with respect to BDI scores: patients with depression (BDI score >= 7, n=55, 40.2%) and patients without depression (BDI score< 17.0 =82, 59.8%). In depressive patients, the majority were female (58%) and lived alone (97%). The weekly erythropoietin dose and CRP levels were higher in patients with depression than in patients without depression and this difference did not reach statistical significance (p>0.05). MIS scores were higher in patients with depression (10.5 +/- 1.8) than in patients without depression (6 +/- 2.2) (p<0.001). Patients with depression (57.3 +/- 1 7.91 had lower MSPSS scores than patients without depression (62.7 +/- 12.5) (p<0.05). There was positive correlation between BDI and MIS, while negative correlation was observed between BDI and MSPSS. In the multivariate linear regression analysis (gender, BUN, albumin, MIS and MSPSS), depression was independently associated with MIS (beta=0.60, t=9.9 p<0.001) and MSPSS (beta=-0.37, t=-6.2 p<0.001). Discussion: Hemodialysis patients needed more social and psychological support. They had higher inflammation and lower social support that associated with the presence of depression, although large-scale studies are needed to confirm our results.