Association of depression with malnutrition in chronic hemodialysis patients

Ja Ryong Koo, Jong Woo Yoon, Seong Gyun Kim, Young Ki Lee, Kook Hwan Oh, Gheun Ho Kim, Hyung Jik Kim, Dong Wan Chae, Jung Woo Noh, Sang Kyu Lee, Bong Ki Son

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121 Scopus citations

Abstract

Background: Depression is the most common psychological complication and may increase mortality in chronic hemodialysis patients. Because depression could be associated with poor oral intake and activation of proinflammatory cytokines that could further increase mortality by malnutrition, we investigated the relation between depression and nutritional status in chronic hemodialysis patients. Methods: Sixty-two Korean patients completed the Beck Depression Inventory (BDI) questionnaire, and the diagnosis of depression was confirmed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for major depressive disorder. Nutritional status was evaluated using serum albumin level, normalized protein catabolic rate, subjective global assessment (SGA), and anthropometric measurement. Results: Mean BDI score was 22.7 ± 11.4, and 35 patients (56.5%) had a BDI score greater than 21, which is the suggested cutoff score for the diagnosis of depression for the Korean population. Of 40 patients who had a score higher than 18 on the BDI, 34 patients met DSM-IV criteria for major depressive disorder. BDI score correlated negatively with a variety of nutritional parameters: serum albumin level (r = -0.47; P < 0.001), normalized protein catabolic rate (r = -0.32; P < 0.05), SGA (r = -0.47; P < 0.01), triceps skinfold thickness (r = -0.40; P < 0.05), midarm muscle circumference (r = -0.57; P < 0.01), and body mass index (r = -0.28; P < 0.05). Multiple regression analysis also identified BDI score as an independent determinant for all kinds of nutritional parameters. Conclusion: In patients on chronic hemodialysis therapy, depression is related closely to nutritional status and could be an independent risk factor for malnutrition.

Original languageEnglish
Pages (from-to)1037-1042
Number of pages6
JournalAmerican Journal of Kidney Diseases
Volume41
Issue number5
DOIs
StatePublished - 1 May 2003

Keywords

  • Depression
  • Hemodialysis (HD)
  • Malnutrition
  • Nutrition

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