Association of biochemical parameters and parameters of inflamation with mental status and quality of life in chronic hemodialysis patients

[B. B. Babović]

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Uvod: Patofiziološki aspekti depresivnosti i anksioznosti kod hronične bolesti bubrega nedovoljno su rasvetljeni, a savremena istraživanja ukazuju na povezanost β2-mikroglobulina i sistemske inflamacije sa mentalnim statusom. Cilj studije bio je da se analizira uticaj biohemijskih i parametara inflamacije na depresivnost, anksioznost i kvalitet života pacijenata na hemodijalizi. Materijal i metode: Istraživanje je dizajnirano kao klinička opservaciona studija preseka kojom je obuhvaćeno 88 pacijenata sa hroničnom bolešću bubrega na programu hemodijalize, 85 pacijenata sa hroničnom bolešću bubrega na konzervativnoj terapiji i 50 zdravih ispitanika. Koncentracija biohemijskih i parametara inflamacije određivana je primenom standardnih laboratorijskih metoda. Za procenu prisustva simptoma depresivnosti i anksioznosti korišćen je PHQ-9 (The Patient Health Questionnare) upitnik, odnosno Bekova skala anksioznosti (BAI). Kvalitet života studijske populacije utvrđen je primenom Health-Related Quality of Life (HRQoL) skora. Rezultati: Pacijenti na hroničnom programu hemodijalize imaju naglašenije simptome depresivnosti i anksioznosti u odnosu na ostatak studijske populacije, tako da je klinički značajna depresivnost zastupljena kod 55,7% ispitanika, a klinička značajna anksioznost kod 27,2% ispitanika. Prisustvo depresivnosti i anksioznosti značajno redukuje kvalitet života pacijenata na hemodijalizi. Postoji statistički značajna pozitivna korelacija koncentracije uremijskih toksina, uključujući i β2-mikroglobulin, i markera inflamacije sa simptomima depresivnosti i anksioznosti kod pacijenata na hemodijalizi. Zaključak: Uremijski toksini i sistemska inflamacija imaju značajnu ulogu u predikciji poremećaja mentalnog statusa i kvaliteta života pacijenata na hroničnom programu hemodijalize.

Introduction: The pathophysiological aspects of depression and anxiety in chronic kidney disease are not sufficiently elucidated, and modern research indicates a connection between β2-microglobulin and systemic inflammation with mental health. The aim of the study was to analyze the influence of biochemical and inflammatory parameters on depression, anxiety, and quality of life of hemodialysis patients. Materials and Methods: The study was designed as a clinical observational cross-sectional study that included 88 patients with chronic kidney disease on hemodialysis, 85 patients with chronic kidney disease on conservative therapy, and 50 healthy subjects. The concentration of biochemical and inflammatory parameters was determined using standard laboratory methods. The PHQ-9 (The Patient Health Questionnaire) and the Beck Anxiety Inventory (BAI) were used to assess the presence of symptoms of depression and anxiety. The quality of life of the study population was determined using the Health-Related Quality of Life (HRQoL) score. Results: Hemodialysis patients have more pronounced symptoms of depression and anxiety compared to the rest of the study population, with clinically significant depression and anxiety represented in 55.7% of the subjects, 27.2% of the subjects, respectively. The presence of depression and anxiety significantly reduces the quality of life of hemodialysis patients. There is a statistically significant positive correlation between the concentration of uremic toxins, including β2-microglobulin, and inflammatory markers with symptoms of depression and anxiety in hemodialysis patients. Conclusion: Uremic toxins and systemic inflammation play a significant role in predicting mental health disorders and quality of life of hemodialysis patients.

β2-mikroglobulin, inflamacija, depresivnost, ansioznost, kvalitet života, hronična bolest bubrega

β2-microglobulin, inflammation, depression, anxiety, quality of life, chronic kidney disease

616.89-008.48-053.6(043.3) 616.61-78:616.89(043.3)

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