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Son Dönem Böbrek Yetmezlikli Yaşlı Hastalarda Beslenme Durumunun Depresyon ve Uyku Bozuklukları ile İlişkisi - Tümüne Kronik İnflamasyon Yol Açabilir mi?

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Association of Nutritional Status with Depression and Sleep Disorders in Elderly End Stage Renal Disease Patients - Does Chronic Inflammation Cause it all?

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Sayfa Aralığı:: 
148-155

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Abstract (Original Language): 
Amaç : Çalışmamızda yaşlı diyaliz hastalarında beslenme durumu ile depresyon ve uyku bozukluğu arasındaki ilişkiyi incelemeyi amaçladık. GERE Ç ve YöntemLER: Çalışmaya diyaliz tedavisi almakta olan 65 yaş üzerindeki 73 hasta alındı. Beslenme durumu “Subjektif Global Değerlendirme (SGD)” ile belirlendi. Hastalar ayrıca “Beck Depresyon Görüşmesi” ve “Pittsburg Uyku Kalitesi İndeksi” ile değerlendirildi. Hastaların demografik ve laboratuvar verileri kaydedildi. Bulgular: SGD sonuçlarına göre, 48 (%65.8) hastanın beslenme durumu iyi düzeyde iken 25 (%34.2) hasta hafif-orta ve ciddi derecede beslenme bozukluğuna sahipti. Beslenme durumu iyi olan hastalar ile malnutrisyonu olan hastalar karşılaştırıldığında, beslenmesi iyi olan grubun daha yüksek albümin (p<0,0001) ve kreatinin (p=0,03) düzeyleri ile vücut kitle indeksine (p<0,01), daha düşük CRP düzeylerine (p<.0001), daha iyi uyku kalitesine (p<0,0001) ve daha düşük depresyon skorlarına (p<0,0001) sahip olduğu görüldü. Hastaları, Grup I (depresyonu olmayan ve iyi uyku kalitesine sahip), Grup II (depresyonu olan ancak iyi uyku kalitesine sahip), Grup III (depresyonu olan ve kötü uyku kalitesine sahip) şeklinde gruplandığımızda Grup III’ün diğer gruplara kıyasla en düşük albümin (p<0,0001) ve en yüksek CRP (p<0,0001) düzeylerine sahip olduğu bulundu. Son uç: Depresyon, uyku bozuklukları ve beslenme durumu birbirleriyle ilişkili önemli etkenlerdir ve malnutrisyonu olan yaşlı diyaliz hastaları inflamatuvar durum ve/veya psikolojik ve uyku bozuklukları varlığı açısından iyi değerlendirilmelidir.
Abstract (2. Language): 
Obj ect Ive: In our study we aimed to analyze the association between nutritional status and depression and sleep disturbance in elderly dialysis patients. Mat erIal and Methods: Seventy-three patients receiving dialysis treatment older than 65 years of age were enrolled in this study. Nutritional status was determined by Subjective Global Assessment (SGA). Patients were also evaluated with Beck Depression Inventory and Pittsburg Sleep Quality Index. Demographic and laboratory data were recorded. Results : According to SGA, 48 (65.8%) patients were well nourished and 25 (34.2%) patients had mild-moderate and severe malnutrition. When the well-nourished and malnourished patients were compared, the well-nourished group had higher albumin (p<.0001) and creatinine (p=.03) levels, higher body mass indices (p<.01), lower CRP levels (p<.0001), better quality of sleep (p<.0001) and lower depression scores (p<.0001) than the malnourished group. When we grouped patients as Group I (not depressive and good sleep quality), Group II (depressive but good sleep quality) and Group III (both depressive and poor sleep quality, we found that Group III had the lowest albumin (p < .0001) and highest CRP (p < .0001) values when compared to the other two groups. Conc lusIon : Depression, sleep disorders, and the nutritional status are important factors which interact with each other and elderly dialysis patients with malnutrition should be well assessed for the presence of any inflammatory status and/or psychological-sleep disorders.

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DOI 10.5262/tndt.2012.1002.08

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