Nutritional status and anxiety-depression relationship in hemodialysis patients
Keywords:Malnutrition, Hemodialysis, Anxiety-depression
Background/Aim: Malnutrition is one of the determinants of most morbidity and mortality in end-stage renal failure (ESRD) patients receiving hemodialysis (HD). Depression is the most common psychological complication among these patients. This study aimed to determine the nutritional status and anxiety-depression level in hemodialysis patients and evaluate the relationship between the two. Methods: This cross-sectional study included 55 routine hemodialysis patients over 18 years of age who were treated in the Department of Internal Diseases of a university hospital between November 2019 and January 2020. Two patients were excluded from the study due to renal transplantation. All patients filled out a two-part Hospital-Anxiety Depression Scale (HAD) and a two-part Mini Nutritional Assessment (MNA) questionnaire. The MNA-short form (MNA-SF) was first used to evaluate the malnutrition status of patients. Those who were identified as at-risk or malnourished with the MNA-SF were also asked to complete the long form. The HAD scale was used to evaluate the levels of depression and anxiety. SPSS 20 statistical package program for statistical analysis. P<0.05 was considered statistically significant. Results: The mean age of the patients was 56.2 (15.9) years; 36 (66%) were female and 18 (34%) were male. Among all, 55.8% and 26.9% of the patients were at risk in terms of depression and anxiety, respectively. Depression prevalence was higher in patients with low MNA-SF scores (P=0.001) and comorbidities (P=0.007). In those with a low MNA-SF score (P=0.001), comorbidities (P=0.008), and high urea levels (P=0.003), anxiety was more common. In patients with an elevated risk of anxiety (P=0.001) and depression (P=0.007), malnutrition risk was significantly higher. Conclusion: Depression is closely related to nutritional status in patients receiving chronic hemodialysis therapy and considered an independent risk factor for malnutrition. Early diagnosis and treatment of hemodialysis patients' psychological problems and regulation and control of nutrition programs can be practical interventions to improve the quality of life of these patients.
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