Association between Depression, Nutritional Status, and Inflammatory Markers in Peritoneal Dialysis Patients

Figures & data

Table 1.  Sociodemographic characteristics of the sample (n: 60).

	Control group (n: 20)	CAPD group (n: 40)
Sociodemographic characteristics
Age (years)	42.60 ± 5.041	41.88 ± 11.741
Gender
Male	11 (55%)	22 (55%)
Female	9 (45%)	18 (45%)
Marital status
Single	3 (15%)	6 (15%)
Married	17 (85%)	32 (80%)
Divorced	0 (0%)	2 (5%)
Education status
Illiterate	2 (10%)	4 (10%)
Primary school	4 (20%)	9 (22.5%)
Literate	12 (60%)	23 (57.5%)
High school	2 (10%)	4 (10%)

Note: CAPD, continuous ambulatory peritoneal dialysis.

Table 2.  Sociodemographic characteristics of the CAPD group (n: 40).

	CAPD group (n: 40)
Sociodemographic characteristics	Nondepressive patients (n: 30)	Depressive patients (n: 10)	P
Age (years)	41.63 ± 11.67	42.60 ± 12.55	NS
Gender*			0.025
Male	20 (66.7%)	2 (20%)
Female	10 (33.3%)	8 (80%)
Marital status			NS
Single	4 (13.3%)	2 (20%)
Married	25 (83.3%)	7 (70%)
Divorced	1 (3.3%)	1 (10%)
Education status			NS
Illiterate	1 (3.3%)	3 (30%)
Literate	6 (20%)	3 (30%)
Primary school	19 (63.3%)	4 (40%)
High school	4 (13.3%)	0 (0%)

Notes: CAPD, continuous ambulatory peritoneal dialysis; NS, nonsignificant.*p < 0.05.

Table 3.  Comparison of the nutritional status parameters, inflammation markers, and results of psychometric tests between CAPD patients and control subjects.

	Control group (n: 20)	CAPD group (n: 40)	p
Nutritional parameters
Hemoglobin (g/dL)*	14.65 ± 1.09	10.34 ± 1.67	<0.001
Total protein (g/dL)*	6.93 ± 0.45	6.37 ± 0.71	0.002
Albumin (g/dL)*	4.39 ± 0.21	3.51 ± 0.52	<0.001
Total cholesterol (mg/dL)	180.4 ± 43.2	186.6 ± 59.8	0.682
Triglyceride (mg/dL)	142.5 ± 53.8	167.9 ± 76.2	0.188
BMI (kg/m^2)	25.95 ± 3.9	25.18 ± 5.1	0.555
SGA*	A = 20 (%100)	A = 26 (%65)	0.030
		B = 14 (%35)
Inflammation markers
ESR (mm/h)*	7.55 ± 5.39	69.83 ± 31.25	<0.001
hs-CRP (mg/dL)	3.17 (3.17–15.10)	3.17 (3.17–57.90)	0.209
TNF-α (pg/mL)	7.00 (2.00–50.00)	24.50 (1.00–800.00)	0.097
IL-1(pg/mL)	13.00 (1.00–41.00)	17.50 (1.00–500.00)	0.311
IL-6 (pg/mL)*	9.00 (1.00–58.00)	28.00 (1.00–200.00)	0.008
Psychometric tests
BDI	4.5 (1–12)	3.5 (1–28)	0.241
HAM-D	3.0 (1–12)	3.0 (1–30)	0.499
HAM-A*	1.0 (0–6)	2.0 (0–9)	0.040

Notes: PD, peritoneal dialysis; BDI, Beck Depression Inventory; HAM-D, Hamilton Depression Rating Scale; HAM-A, Hamilton Anxiety Rating Scale; BMI, body mass index; ESR, erythrocyte sedimentation rate; hs-CRP, high-sensitive C-reactive protein; IL, interleukin; TNF-α, tumor necrosis factor-α; CAPD, continuous ambulatory peritoneal dialysis.*p < 0.05.

Table 4.  Comparison of the nutritional status parameters, inflammation markers, and results of psychometric tests in PD patients with and without depressive disorder.

	Nondepressive patients	Depressive patients (n: 10)
	(n: 30)	Before treatment	After treatment
Nutritional parameters
Hemoglobin (g/dL)	10.60 ± 1.74	9.53 ± 1.11	9.55 ± 2.35
Total protein (g/dL)	6.38 ± 0.63	6.35 ± 0.94	6.21 ± 0.62
Albumin (g/dL)	3.55 ± 0.48	3.40 ± 0.60	3.21 ± 0.44
Total cholesterol (mg/dL)	179.7 ± 58.5	207.1 ± 61.9	200.5 ± 48.2
Triglyceride (mg/dL)	160.5 ± 63.4	189.8 ± 107.3	165.8 ± 92.0
BMI (kg/m^2)	25.2 ± 4.8	25.1 ± 6.2	24.7 ± 5.6
SGA	A = 21 (%70)	A = 5 (%50)	A = 5 (%50)
	B = 9 (%30)	B = 5 (%50)	B = 5 (%50)
Inflammation markers
ESR (mm/h)	63.93 ± 31.21*	87.50 ± 25.14	95.10 ± 29.84
hsCRP (mg/dL)	3.17 (3.17–20.50)	9.01 (3.17–57.9)	6.48 (3.17–41.40)
TNF-α (pg/mL)	24.50 (1.00–800.00)	25.50 (1.00–800.00)	220.00 (2.00–800.00)
IL-1 (pg/mL)	14.00 (1.00–500.00)	25.00** (3.00–340.00)	374 (3.00–500.00)
IL-6 (pg/mL)	27.00 (1.00–200.00)	46.50** (5.00–200.00)	200.00 (160.00–200.00)
Psychometric tests
BDI	3.0 (1–5)*	23.5 (19–28)**	14.5 (8–25)
HAM-D	2.5 (1–6)*	24.5 (20–30)**	12.5 (6–25)
HAM-A	2.0 (0–4)*	6.5 (3–9)**	3.0 (1–4)

Notes: PD, peritoneal dialysis; ESR, erythrocyte sedimentation rate; hsCRP, high-sensitive C-reactive protein; BDI, Beck Depression Inventory; HAM-D, Hamilton Depression Rating Scale; HAM-A, Hamilton Anxiety Rating Scale; SGA, subjective global assessment; BMI, body mass index; TNF-α, tumor necrosis factor-α; IL, interleukin.

*p < 0.05 in patients without depressive disorder compared to those with depressive disorder. **p < 0.05 in depressive patients; evaluations were performed before antidepressive treatment compared to evaluations after antidepressive treatment.