Kidney Research and Clinical Practice (Jun 2012)

The association of nutrition with interdialytic weight gain and depressive disorder in hemodialysis patients

  • Hyun Gyung Kim,
  • Yu Seon Yun,
  • Byung Soo Kim,
  • Sun Ae Yoon,
  • Young Ok Kim

DOI
https://doi.org/10.1016/j.krcp.2012.04.437
Journal volume & issue
Vol. 31, no. 2
p. A45

Abstract

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Malnutrition was reported to occur in 23–76% and known as an important predictor of increased mortality in maintenance hemodialysis (HD) patients. This study was performed to evaluate the association of nutrition with interdialytic weight gain (IDWG) and depression in HD patients. Sixty-five HD patients for at least 3 months were enrolled. We investigated malnutrition by OSND (Objective score of Nutrition on dialysis) score and depressive disorder by Montgomery depression rating scale and Hamilton depression rating scale. We compared the clinical and biochemical profiles according to the presence of malnutrition. Mean age of the patients was 55.7±12.6 years and patients with diabetes accounted 55.4%. Mean duration of HD was 36.2±32.0 (4–129) months. Depressive disorder was diagnosed in 21 (32.3%), Malnutrition (OSND score1 kg/day) in 40 (61.5%) out of the 65 HD patients. Patients with malnutrition had lower incidence of large IDWG (45.8% vs 70.7%, p=0.046) and depression (19.5% vs 54.1%, p=0.004) than those without. BMI (21.2±3.0 vs 23.4±3.0 kg/m2 ,p=0.006), TSF (triceps skin fold thickness, 8.8±4.2 vs 15.0±6.2 mm, p<0.001), MAC (mid-arm circumference, 23.6±2.7 vs 26.4±3.0 cm, p=0.001), serum albumin (3.6±0.3 vs 3.8±0.2 g/dL, p=0.029) and total cholesterol (142.5±29.2 vs 169.7±31.2 mg/dL, p=0.001) were also lower in patients with malnutrition, compared to the patients without malnutrition. There was no difference in age, gender, diabetes and HD duration between the two groups. In multivariate analysis, Depressive disorder was an independent risk factor for malnutrition. Fig. Multivariate analysis of risk factors for malnutrition in chronic HD patients (n=65) (R2= 0.285). In conclusion, we suggest that the depressive disorder may be considered in HD patients at the time of the assessment of nutritional status in maintenance HD patients. In addition, it is hard to use large IDWG as an indicator of nutrition in maintenance HD patients.