Buradasınız

Anasayfa » Content

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

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

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2012
DOI: 
DOI 10.5262/tndt.2012.1002.08

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
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.
Bookmark/Search this post with
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.
FULL TEXT (PDF): 
PDF icon arastrmx_172977_21_pp_148-155.pdf
  • 2
148-155
  • Turkish

REFERENCES

References: 

1. Collins AJ, Kasiske B, Herzog C, Chavers B, Foley R, Gilbertson
D, Grimm R, Liu J, Louis T, Manning W, McBean M, Murray A, St
Peter W, Xue J, Fan Q, Guo H, Li Q, Li S, Qiu Y, Li S, Roberts T,
Skeans M, Snyder J, Solid C, Wang C, Weinhandl E, Zhang R, Arko
C, Chen SC, Dalleska F, Daniels F, Dunning S, Ebben J, Frazier
E, Hanzlik C, Johnson R, Sheets D, Wang X, Forrest B, Berrini D,
Constantini E, Everson S, Eggers P, Agodoa L: Excerpts from the
United States Renal Data System 2006 Annual Data Report. Am J
Kidney Dis 2007; 49 (Suppl 1): A6-7, S1-296
2. Gul A, Aoun N, Trayner EM Jr: Why do patients sleep on dialysis?
Semin Dial 2006; 19 (2): 152-157
3. Zimmermann PR, Poli de Figueiredo CE, Fonseca NA: Depression,
anxiety and adjustment in renal replacement therapy: A quality of
life assessment. Clin Nephrol 2001; 56 (5): 387-390
4. Iliescu EA, Coo H, McMurray MH, Meers CL, Quinn MM, Singer
MA, Hopman WM: Quality of sleep and health-related quality of
life in haemodialysis patients. Nephrol Dial Transplant 2003; 18(1):
126-132
5. Parker KP, Kutner NG, Bliwise DL, Bailey JL, Rye DB: Nocturnal
sleep, daytime sleepiness and quality of life in stable patients on
hemodialysis. Health Qual Life Outcomes 2003; 1: 68
6. Taskapan H, Ates F, Kaya B, Emul M, Kaya M, Taskapan C, Sahin I:
Psychiatric disorders and large interdialytic weight gain in patients
on chronic haemodialysis. Nephrology (Carlton) 2005; 10 (1): 15-20
7. Kalender B, Ozdemir AC, Koroglu G: Association of depression
with markers of nutrition and inflammation in chronic kidney
disease and end-stage renal disease. Nephron Clin Pract 2006; 102
(3-4): e115-121
8. Koo JR, Yoon JY, Joo MH, Lee HS, Oh JE, Kim SG, Seo JW, Lee
YK, Kim HJ, Noh JW, Lee SK, Son BK: Treatment of depression
and effect of antidepression treatment on nutritional status in
chronic hemodialysis patients. Am J Med Sci 2005; 329 (1):1-5
9. Kalantar-Zadeh K, Kopple JD: Relative contributions of nutrition
and inflammation to clinical outcome in dialysis patients. Am J
Kidney Dis 2001; 38 (6): 1343-1350
10. Laws RA, Tapsell LC, Kelly J: Nutritional status and its relationship
to quality of life in a sample of chronic hemodialysis patients. J Ren
Nutr 2000; 10 (3): 139-147
11. Enia G, Sicuso C, Alati G, Zoccali C: Subjective global assessment
of nutrition in dialysis patients. Nephrol Dial Transplant 1993; 8
(10): 1094-1098
12. Clinical practice guidelines for nutrition in chronic renal failure. K/
DOQI, National Kidney Foundation. Am J Kidney Dis 2000; 35 (6
Suppl 2): 1-140
13. Richter P, Werner J, Heerlein A, Kraus A, Sauer H: On the validity
of the Beck Depression Inventory. A review. Psychopathology
1998; 31 (3): 160-161
14. Buysse, DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer
DJ: The Pittsburgh Sleep Quality Index: A new instrument for
psychiatric practice and research. Psychiatry Res, 1989; 28 (2): 193-
213
15. German L, Feldblum I, Bilenko N, Castel H, Harman-Boehm I,
Shahar DR: Depressive symptoms and risk for malnutrition among
hospitalized elderly people. J Nutr Health Aging 2008; 12 (5):
313-318
16. Feldblum I, German L, Bilenko N, Shahar A, Enten R, Greenberg
D, Harman I, Castel H, Shahar DR: Nutritional risk and health care
use before and after an acute hospitalization among the elderly.
Nutrition 2009; 25 (4): 415-420
17. Feldblum I, German L, Castel H, Harman-Boehm I, Bilenko N,
Eisinger M, Fraser D, Shahar DR: Characteristics of undernourished
older medical patients and the identification of predictors for
undernutrition status. Nutr J 2007; 6: 37
18. Parker KP, Kutner NG, Bliwise DL, Bailey JL, Rye DB: Nocturnal
sleep, daytime sleepiness, and quality of life in stable patients on
hemodialysis. Health Qual Life Outcomes 2003; 1: 68
19. Iliescu EA, Coo H, McMurray MH, Meers CL, Quinn MM, Singer
MA, Hopman WM: Quality of sleep and health-related quality of
life in haemodialysis patients. Nephrol Dial Transplant 2003; 18
(1): 126-132
20. Iliescu EA, Yeates KE, Holland DC: Quality of sleep in patients
with chronic kidney disease. Nephrol Dial Transplant 2004; 19 (1):
95-99
21. Sabbatini M, Minale B, Crispo A, Pisani A, Ragosta A, Esposito R,
Cesaro A, Cianciaruso B, Andreucci VE: Insomnia in maintenance
haemodialysis patients. Nephrol Dial Transplant 2002; 17 (5):
852-856
22. Sabbatini M, Pisani A, Mirenghi F, Cianciaruso B, Crispo A: The
impact of haemoglobin on the quality of sleep in haemodialysis
patients: Which is the truth? Nephrol Dial Transplant 2003; 18 (1):
126-132
23. Rambod M, Bross R, Zitterkoph J, Benner D, Pithia J, Colman
S, Kovesdy CP, Kopple JD, Kalantar-Zadeh K: Association of
Malnutrition-Inflammation Score with quality of life and mortality
in hemodialysis patients: A 5-year prospective cohort study. Am J
Kidney Dis 2009; 53 (2): 298-309
24. Muscaritoli M, Molfino A, Bollea MR, Rossi Fanelli F: Malnutrition
and wasting in renal disease. Curr Opin Clin Nutr Metab Care 2009;
12 (4): 378-383
25. Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH: A
malnutrition-inflammation score is correlated with morbidity and
mortality in maintenance hemodialysis patients. Am J Kidney Dis
2001; 38 (6): 1251-1263
26. Bilgic A, Akgul A, Sezer S, Arat Z, Ozdemir FN, Haberal M:
Nutritional status and depression, sleep disorder and quality of life
in hemodialysis patients. J Ren Nutr 2007; 17 (6): 381-388
27. Li ZJ, An X, Mao HP, Wei X, Chen JH, Yang X, Zhou SF, Li ZB, Yu
XQ: Association between depression and malnutrition-inflammation
complex syndrome in patients on continuous ambulatory peritoneal
dialysis. Int Urol Nephrol 2011; 43 (3): 875-882
28. Micozkadioglu H, Micozkadioglu I, Zumrutdal A, Erdem A,
Ozdemir FN, Sezer S, Haberal M: Relationship between depressive
affect and malnutrition-inflammation complex syndrome in
haemodialysis patients. Nephrology 2006; 11 (6): 502-505
29. Maes M: Major depression and activation of the inflammatory
response system. Adv Exp Med Biol 1999; 461: 25-46
30. Leonard BE: The immune system, depression and the action of
antidepressants. Prog Neuropsychopharmacol Biol Psychiatry
2001; 25 (4): 767-780
31. Owen WF Jr, Lew NL, Liu Y, Lowrie EG, Lazarus JM: The urea
reduction ratio and serum albumin concentration as predictors of
mortality in patients undergoing hemodialysis. N Engl J Med 1993;
329 (14): 1001-1006
32. Khalil AA, Lennie TA, Frazier SK: Understanding the negative
effects of depressive symptoms in patients with ESRD receiving
hemodialysis. Nephrol Nurs J 2010; 37 (3): 289-295
33. Kalantar-Zadeh K, Block G, McAllister CJ, Humphreys MH,
Kopple JD: Appetite and inflammation, nutrition, anemia, and
clinical outcome in hemodialysis patients. Am J Clin Nutr 2004; 80
(2): 299-307

Thank you for copying data from http://www.arastirmax.com