Exploring the correlation of diabetes mellitus, depression and dementia in chronic haemodialysis patients

Abstract

Introduction: Patients with End Stage Renal Disease on haemodialysis often suffer from depression and dementia. However, the relation between diabetes and depression and/or dementia in haemodialysis patients has not yet been efficiently researched. Objective: The purpose of the study was to explore the effect of diabetes mellitus on depression and dementia on haemodialysis patients. Methodology: Fifty three patients, out of which 27 diabetics, were on haemodialysis for 28.34 (±56.36) months. All patients answered the Mini Mental State Examination (MMSE) test and Hospital Anxiety and Depression Scale (HADS) in an interview during haemodialysis session in order to assess the level of depression and dementia. Moreover, blood samples were taken in order to determine haemoglobin, dialysis adequacy (kt/V), levels of blood sodium, potassium, calcium and phosphorus, as well as the levels of C-reactive protein (CRP). Statistical analysis was performed with SPSS 17.0. Results: The level of depression and dementia for the total patients was correspondent to a moderate level of illness (13.91±10.56 and 15.00±5.49, respectively). In a comparison between diabetics and nondiabetics the results indicated a statistically significant difference for diabetics who displayed a highlevel of depression (17.63±10.63 vs 10.04±9.15, p<0.05). The level of dementia was that of an average degree both for diabetics and non-diabetics, however there was a significant difference between the two groups (13.19±5.19 vs 16.88±5.23, p<0.05). In the non-diabetic group a noteworthy difference regarding the depression level between men and women was established (8.79±7.70 vs 13.43±12.35, p<0.05). Nevertheless, the same distinguishable difference concerning the level of dementia was not statistically determined. In diabetics a substantial difference between the two genders was not determined. A significance between the levels of CRP in non-diabetics (r=0.487, p<0.05) was found, but not in the diabetic patients group. As far as the rest of the parameters, there was no noteworthy correlation found. Conclusions: Depression was closely related with diabetes in haemodialysis patients and is of a higher degree for the diabetics. Dementia has higher prevalence in those suffering from diabetes but not alarmingly high. Nevertheless, more prolonged studies are needed in order to determine the cognitive status of haemodialysis patients, which will probably reveal interesting parameters

Keywords

• Dialysis
• Diabetes
• Dementia
• MMSE
• HADS