Depression Is Associated With Muscle Mass And Strength In Patients With End Stage Renal Disease

Abstract

Depression is the most common psychiatric complication in patients with end-stage renal disease (ESRD). Sarcopenia, defined as loss of muscle mass and strength, is expected to be associated with depression, because both are closely linked to physical inactivity and functional impairment. We investigated the association of sarcopenia with depression in patients with ESRD. A total of 115 patients undergoing hemodialysis (HD) were included in this study. Muscle mass was assessed by lean tissue index (LTI) using portable whole body bioimpedance spectroscopy, and muscle strength was measured with handgrip strength (HGS). Depression was defined as Beck Depression Inventory-II (BDI-II) score ≥16. About 60% of prevalent HD patients had depression. Compared to subjects without depression, depressed patients had a higher prevalence of sarcopenia (45.5 vs. 8.2%, p<0.001) and significantly increased serum IL-6 and hs-CRP level. However, (pre)albumin and body mass index (BMI) failed to correlate with BDI-II. HGS and LTI had a consistent negative effect on BDI-II even after adjusting other parameters including inflammation. In multivariate analysis, lower , increased IL-6 and β2-microglobulin,and sarcopenia were significant predictors for depression; sarcopenia was most powerful [odds ratio 9.01, 95% CI 3.60-12.22, p=0.001]. In conclusion, the prevalence of sarcopenia and depression was considerably high and and the presence of sarcopenia was an important predictor for depression.