Depression, quality of life, and body composition in patients with end-stage renal disease: a cohort study

• Published in: Revista brasileira de psiquiatria Vol. 38; no. 4; pp. 301 - 306
• Main Authors: Barros, Annerose, Costa, Bartira E da, Mottin, Claudio C, d'Avila, Domingos O
• Format: Journal Article
• Language: English
• Published: Brazil Associação Brasileira de Psiquiatria 01-10-2016; Associação Brasileira de Psiquiatria (ABP)
• Subjects: Adult; Aged; Body Composition; depression; Depression - physiopathology; Female; Follow-Up Studies; hemodialysis; Humans; Kidney Failure, Chronic - psychology; Kidney Failure, Chronic - therapy; Male; Middle Aged; mortality; Nutritional Status; Original; Prospective Studies; PSYCHIATRY; quality of life; Quality of Life - psychology; Renal Dialysis; hemodialysis; mortality; depression; quality of life; Body composition
• ISSN: 1516-4446; 1809-452X; 1809-452X
• DOI: 10.1590/1516-4446-2015-1681

To prospectively evaluate depressive symptoms, nutritional status, and quality of life (QoL) and search for possible associations in patients with end-stage renal disease undergoing hemodialysis.
A cohort study of 104 adult patients with end-stage renal disease undergoing hemodialysis was conducted. Anthropometric, clinical, and biochemical variables were evaluated after a midweek hemodialysis session. The participants' body composition was assessed by direct segmental multi-frequency bioimpedance analysis. The WHOQOL-Bref questionnaire was used to evaluate QoL. Participants were separated into two groups - depressive symptoms and no depressive symptoms - at inclusion and evaluated annually for 2 years thereafter using the Beck Depression Inventory. Survival analysis used the Kaplan-Meier method and Cox regression analysis for the goodness of fit of associated factors. All-cause mortality was the outcome of interest.
Participants' mean age was 55.3±15.6 years, 60% were male, and the median time on hemodialysis was 17.5 (8.0-36.8) months. Thirty-two patients had depressive symptoms and a significantly lower QoL compared with the 72 patients in the no depressive symptoms group. The fitted outcome model showed that lean body mass had a protective effect against all-cause mortality (hazard ratio [HR] = 0.89; 95%CI 0.80-0.99; p = 0.038).
Depressive symptoms were highly prevalent in the cohort, and correlated with the physical and psychological components of the QoL life questionnaire, as well as with C-reactive protein and phosphorus levels. Lean body mass was protective for the assessed outcome.