J Korean Med Sci.  2012 Jan;27(1):64-71. 10.3346/jkms.2012.27.1.64.

Lower Residual Renal Function is a Risk Factor for Depression and Impaired Health-Related Quality of Life in Korean Peritoneal Dialysis Patients

• Park HC
• Lee H
• Lee JP
• Kim DK
• Oh KH
• Joo KW
• Lim CS
• Kim YS
• Ahn C
• Oh YK

• KMID: 1792981
• DOI: http://doi.org/10.3346/jkms.2012.27.1.64

Abstract

We retrospectively evaluated demographic and biochemical parameters associated with depression and health-related quality of life (HRQOL) in maintenance peritoneal dialysis (PD) patients. This study included 105 patients maintaining PD at Seoul National University Hospital. Data were collected from electronic medical record. Korean Beck's Depression Inventory and Korean version of Kidney Disease Quality of Life short form, version 1.3 were used to evaluate depression and HRQOL, respectively. Moderate to severe depression was found in 24.8% of patients. Patients with lower normalized protein equivalent of nitrogen appearance (nPNA) (< 1.2 g/kg/day), lower weekly renal Kt/V(urea) (< 0.2), and lower serum albumin level (< or = 4.0 g/dL) were associated with depression (P < 0.05). Among them, lower weekly renal Kt/V(urea) was the only independent risk factor associated with depression (OR = 3.1, P = 0.007). Depressed patients showed significantly lower scores in every dimension of HRQOL (P < 0.001). Lower weekly renal Kt/V(urea) (beta = 0.24, P = 0.005) and lower nPNA (beta = 0.15, P = 0.03) were the independent risk factors associated with lower kidney dialysis component summary, whereas lower plasma hemoglobin level was the consistent risk factor for lower physical component summary (beta = 0.22, P = 0.03) and mental component summary (beta = 0.22, P = 0.01). Depression is a prevalent psychological problem in PD population. Residual renal function is the most important factor associated with depression and impaired HRQOL in PD patients.

Keyword

Peritoneal Dialysis; Depression; Health-Related Quality of Life; Residual Renal Function; Beck's Depression Inventory; KDQOL-SF

MeSH Terms

Adult
Aged
Demography
Depression/*etiology
Female
Health Status
Hemoglobins/analysis
Humans
Kidney Diseases/*complications/physiopathology/*psychology
Male
Middle Aged
Peritoneal Dialysis
*Quality of Life
Republic of Korea
Retrospective Studies
Risk Factors
Serum Albumin/analysis
Software

Figure

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  Fig. 1 Comparison of KDQOL-SF™ scores between depressed and non-depressed patients. *P < 0.05; †P < 0.01. (A) SF-36 domain scores (PF, Physical function; RP, Role physical; BP, Bodily pain; GH, General health; VT, Vitality; SF, Social function; RE, Role Emotional; MH, Mental health). (B) Disease-specific domain scores (DS, Symptom problem; DE, Effects of kidney disease; DB, Burden of kidney disease; WS, Work status; CF, Cognitive function; SI, Quality of social interaction; SF, Sexual function; SL, Sleep; SS, Social support; SE, Staff encouragement; PS, Patient satisfaction). (C) Composite summary scores (physical component summary [PCS], mental component summary [MCS], and kidney disease component summary [KDCS]).

• 

  Fig. 2 Relationship between Beck's Depression Index (BDI) score and each component summary score of KDQOL-SF™. (A) Physical component summary (PCS) and BDI scores (r2 = 0.42, P < 0.001). (B) Mental component summary (MCS) and BDI scores (r2 = 0.435, P < 0.001). (C) Kidney disease component summary (KDCS) and BDI scores (r2 = 0.536, P < 0.001).

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