The relationship between depression - Malnutrition and echocardiographic-blood pressure parameters in chronic hemodialysis patients
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2008
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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 ≥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. © Springer Science+Business Media B.V. 2008.
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Blood Pressure Monitoring, Ambulatory , Circadian Rhythm , Depression , Echocardiography , Female , Humans , Kidney Failure, Chronic , Male , Malnutrition , Middle Aged , Psychiatric Status Rating Scales , Statistics, Nonparametric , albumin , iron , adult , age distribution , aged , article , atherosclerosis , blood pressure monitoring , blood pressure regulation , clinical assessment , controlled study , correlation analysis , depression , disease association , echocardiography , female , geometry , heart left ventricle hypertrophy , hemodialysis patient , human , hypervolemia , inferior cava vein , inflammation , kidney function test , lowest income group , major clinical study , male , malnutrition , questionnaire , scoring system , sex difference , treatment duration