Ann Rehabil Med.  2012 Oct;36(5):702-707.

Depression and Life Quality in Chronic Renal Failure Patients with Polyneuropathy on Hemodialysis

• Ku DY
• Park YS
• Chang HJ
• Kim SR
• Ryu JW
• Kim WJ

Abstract

OBJECTIVE
To investigate the relationship between severity of peripheral polyneuropathy (PPN) and degree of depression and quality of life in chronic renal failure (CRF) patients on hemodialysis (HD). METHOD: Forty seven chronic renal failure patients on hemodialysis were recruited (22 male, 25 female, mean age of 63.17+/-12.52) and etiology, disease duration, hemodialysis duration, creatinine and hemoglobin were recorded. Motor and sensory nerve conduction studies were carried out on bilateral median, ulnar, tibial and peroneal nerves for diagnosis of polyneuropathy according to our laboratory criteria. The Korean version of Beck depression inventory (BDI) questionnaire translated into Korean for diagnosis of depression, and Korean version of Short Form 36 health survey (SF-36) questionnaire for measurement of general health level were measured in those diagnosed with uremic PPN.
RESULTS
Out of 52 patients, 47 were diagnosed with polyneuropathy and mean score for BDI was 18.49+/-9.18. Mean scores for each of Mental Component Summary (MCS) and Physical Component Summary (PCS) of SF-36 were 50.84+/-15.42 and 47.41+/-18.68. The correlation between the scores and polyneuropathy were analyzed by Pearson coefficient. The MCS score was the significant (p<0.05) correlation parameter with depression (R=-0.635) and the PCS score was the only parameter with a significant (p<0.05) correlation with polyneuropathy (R=-0.340).
CONCLUSION
Uremic polyneuropathy is commonly observed in chronic renal failure patients on hemodialysis. Depression in CRF with uremic PPN is affected by psychological factors other than the PPN itself.

Keyword

Neuropathy; Chronic renal failure; Depression; Quality of life

MeSH Terms

Creatinine
Depression
Female
Health Status
Health Surveys
Hemoglobins
Humans
Kidney Failure, Chronic
Male
Neural Conduction
Peroneal Nerve
Polyneuropathies
Quality of Life
Renal Dialysis
Surveys and Questionnaires
Creatinine
Hemoglobins

Reference

1. Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL. Harrison's principles of inernal medicine. 2011. 15th ed. New York: The McGraw-Hill Companies;p. 1551–1567.

2. Hegstrom RM, Murray JS, Pendras JP, Burnell JM, Scribner BH. Two year's experience with periodic hemidialysis in the treatment of chronic uremia. Trans Am Soc Artif Intern Organs. 1962; 8:266–280. PMID: 13905956.

3. Jurcić D, Bilic A, Schwarz D, Orsanic D, Gabric M, Spoljaric L, Mihanovic M. Clinical Course of uremic neuropathy in long-term hemodialysis. Coll Antropol. 2008; 32:771–775. PMID: 18982751.

4. Asbury AK, Victor M, Adams RD. Uremic polyneuropathy. Arch Neurol. 1963; 8:413–428. PMID: 13965111.

5. Dyck PJ, Johnson WJ, Lambert EH, O'Brien PC. Segmental demyelination secondary to axonal degeneration in uremic neuropathy. Mayo Clin Proc. 1971; 46:400–431. PMID: 4326086.

6. Nowicki M, Zwiech R, Dryja P, Sobanski W. Autonomic neuropathy in hemodialysis patients: questionnaires versus clinical tests. Clin Exp Nephrol. 2009; 13:152–155. PMID: 19153803.

7. Chang JS, Chang EJ, Jung CH. The factors affecting ganeral coping styles in chronic renal failure patients. J Korean Neuropsychiatr Assoc. 2003; 42:396–402.

8. Park HC, Yoon HB, Son MJ, Jung ES, Joo KW, Chin HJ, Oh KH, Lim CS, Kim YS, Ahn C, et al. Depression and health-related quality of life in maintenance hemodialysis patients. Clin Nephrol. 2010; 73:374–380. PMID: 20420798.

9. Mitz M, Di Benedetto M, Kilingbeil GE, Melvin JL, Piering W. Neuropathy in end-stage renal disease sedcondary to primary renal disease and diabetes. Arch Phys Med Rehabil. 1984; 65:235–238. PMID: 6324717.

10. Shin HS, Yoon CH, Yeum HC, Kim HG, Kang NH. The usefulness of sympathetic skin response in patients with chronic renal failure. J Korean Acad Rehabil Med. 2000; 24:1129–1135.

11. Cho JH, Kwon YW, Ahn JH, Lee JH, Kim SB. Somatosensory evoked potential study in patients with polyneuropathy with chronic renal failure. J Korean Acad Rehabil Med. 1997; 21:553–557.

12. Davison SN, Jhangri GS. Impact of pain and symptom burden on the health-related quality of life of hemodialysis patients. J Pain Symptom Manage. 2010; 39:477–485. PMID: 20303025.

13. Chen CK, Tsai YC, Hsu HJ, Wu IW, Sun CY, Chou CC, Lee CC, Tsai CR, Wu MS, Wang LJ. Depression and suicide risk in hemodialysis patients with chronic renal failure. Psychosomatics. 2010; 51:528. PMID: 21051686.

14. Hong YJ, Ock JH, Kong JM, Kim YG, Kim JG. A Comparative study concerning the psychopathologies between the patients with chronic renal failure and those with chronic hepatitis: focused on Medically-ill outpatients compared with. J Korean Neuropsychiatr Assoc. 2002; 41:486–497.

15. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of effects of anxiety and depression on patient adherence. Arch Intern Med. 2000; 160:2101–2107. PMID: 10904452.

16. Agganis BT, Weiner DE, Giang LM, Scott T, Tighiouart H, Griffith JL, Sarnak MJ. Depression and cognitive function in maintenance hemodialysis patients. Am J Kidney Dis. 2010; 56:704–712. PMID: 20673602.

17. Griva K, Stygall J, Hankins M, Davenport A, Harrison M, Newman SP. Cognitive impairment and 7-year mortality in dialysis patients. Am J Kidney Dis. 2010; 56:693–703. PMID: 20800327.

18. Kim DH, Kim TH, Kim JL, Lee H, Kim SA, Oh KY. Screening test for depression using the SF-36 health survey in patients with chronic musculoskeletal pain. J Korean Acad Rehabil Med. 2007; 31:434–439.

19. Park JI, Kim SJ, Jung HH, Lee JH. The association of nocturnal sleep pattern with the quality of life in chronic renal failure patients on hemodialysis. J Korean Neuropsychiatr Assoc. 2006; 45:145–151.

20. Lee TB, Han CH, Son BK. The preliminary study of the effects of antidepressant treatment on the depressive symptoms and the nutritional indexes in the patients with chronic renal failure on maintenance hemodialysis. J Korean Neuropsychiatr Assoc. 2000; 39:1102–1110.

21. Andrade CP, Cruz MC, Urrutia M, Pereira O, Draibe SA, Nogueira-Martins LA, Sesso R. Evaluation of depressive symptoms in patients with chronic renal failure. J Nephrol. 2010; 23:168–174. PMID: 20119932.