Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study
International Journal of Biomedical Engineering and Clinical Science
Volume 6, Issue 2, June 2020, Pages: 48-54
Received: May 5, 2020;
Accepted: Jun. 15, 2020;
Published: Jun. 29, 2020
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Yoshihiro Tsuji, Department of Medical Engineering, Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan
Naoki Suzuki, Department of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan
Yasumasa Hitomi, Department of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan
Yuko Mizuno-Matsumoto, Graduate School of Applied Informatics, University of Hyogo, Kobe, Japan
Toshiko Tokoro, Department of Nephrology, Tojinkai Satellite Clinic, Kyoto, Japan
Masato Nishimura, Cardiovascular Division, Tojinkai Satellite Clinic, Kyoto, Japan
Background: Iron status has a critical role in depressive symptoms, but evaluation of depressive symptoms associated with iron metabolism is not usually included as a clinical parameter in hemodialysis (HD) patients. We aimed to assess the correlations between depressive symptoms and clinical, demographic, and laboratory variables including iron metabolism. Methods: One hundred and thirty-eight HD patients were evaluated in this study. The Beck Depression Inventory Second Edition (BDI−II) was used to quantify levels of depressive symptoms. BDI−II scores ≥ 14 were defined as depressive symptoms. Mean age, duration of HD, haemoglobin levels, serum ferritin levels, serum iron levels, transferrin saturation (TSAT), total iron binding capacity, serum albumin levels, and C-reactive protein were included in the model. Patients were categorized into four groups according to serum ferritin levels and TSAT. Backward stepwise logistic regression analysis was performed and odds ratios (ORs) and 95% confidence intervals derived. Results: Depressive symptoms were significantly associated with increased serum ferritin levels (OR, 1.010; p=0.0008). Compared with group 1 (ferritin <100 ng/dL, TSAT ≥20%) as reference, ORs for depressive symptoms were significantly increased in group 4 (ferritin ≥100 ng/dL, TSAT < 20%) (OR, 6.419; p=0.0073). Conclusion: Higher serum ferritin levels and decreased iron utilization efficiency were found to be involved in depressive symptoms among patients undergoing HD. Understanding the pathophysiology of depressive symptoms could provide insights into the design of clinical iron management in HD patients.
Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study, International Journal of Biomedical Engineering and Clinical Science.
Vol. 6, No. 2,
2020, pp. 48-54.
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