Korean J Nephrol.  2010 May;29(3):342-349.

Depression, Inflammation, and Oxidative Stress in Peritoneal Dialysis Patients: Is There a Relationship?

• Shin HS
• Park SS
• Park JY
• Lee EY
• Park NY
• Jung YS
• Rim H

Abstract

PURPOSE
This study aimed to investigate the features and severity of depressive symptoms in peritoneal dialysis patients, and the relationship of depressive symptoms with levels of inflammation and oxidative stress (OS).
METHODS
The diagnosis of depression was made using DSM-IV-TR and the depressive symptoms were evaluated using the Hamilton Rating Scale for Depression (HRSD) via a semi-structured interview. Levels of thiobarbituric acid-reactive substances (TBARs) were determined as markers of lipid peroxidation. Superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activities were measured as antioxidants.
RESULTS
19 (28.8%) patients were diagnosed with depression (Major Depressive Disorder was 18.2%, Dysthymic disorder was 10.6%). OS markers were not different between patients with and without depression. Compared to non-depressed patients, depressed patients showed significantly higher depressed mood, feelings of guilt, suicidal ideation, sleep disturbances, psychomotor retardation, agitation, psychic and somatic anxiety, lower levels of work and activities, gastrointestinal and general somatic symptoms, and hypochondriasis. There was a significant positive correlation between HRSD scores and peritonitis (gamma=0.297, p=0.016), levels of high sensitivity C-reactive protein (hsCRP) (gamma=0.406, p=0.001) and ferritin (gamma=0.276, p=0.025), while there was a significant negative correlation between scores of HRSD and levels of albumin (gamma=-0.313, p=0.010).
CONCLUSION
Major depressive disorder and dysthymic disorder were not related to inflammation and oxidative stress in peritoneal dialysis patients; however, depressive symptom severity was correlated with markers of inflammation and malnutrition. These results suggest that inflammation could have influence on depressive symptoms in peritoneal dialysis patients.

Keyword

Peritoneal dialysis; Oxidative stress; Depression

MeSH Terms

Anxiety
C-Reactive Protein
Catalase
Depression
Depressive Disorder
Depressive Disorder, Major
Dihydroergotamine
Dysthymic Disorder
Ferritins
Glutathione Peroxidase
Guilt
Humans
Hypochondriasis
Inflammation
Lipid Peroxidation
Malnutrition
Oxidative Stress
Peritoneal Dialysis
Peritonitis
Suicidal Ideation
Superoxide Dismutase
C-Reactive Protein
Catalase
Dihydroergotamine
Ferritins
Glutathione Peroxidase
Superoxide Dismutase