Abstract
Background/Aims: Depression represents the most frequent psychiatric disorder in nephrology. Cytokines, and especially IL-6, were found to be elevated in depressed patients with normal renal function. The objective of this pilot study was to examine the relationship between depression and cytokines (IL-6, TNF-α, and IL-10) in patients with end-stage kidney disease (ESKD). Methods: We studied 44 stable patients with ESKD for 71 ± 66 months (32 males; 64 ± 13 years; 27 on hemodialysis and 17 on peritoneal dialysis). The control group included 20 healthy age- and gender-matched individuals (12 males; 60 ± 12 years). Depression was assessed by the Zung Self-Rating Depression Scale (ZS). Nephelometry for high-sensitivity CRP and ELISA kits for IL-6, IL-10 and TNF-α were used. Results: Compared to controls, patients with ESKD had higher ZS scores (56.8 ± 16.8 vs. 44 ± 12.7, p < 0.01), WBC (7,987 ± 2,347 vs. 6,413 ± 870/mm<sup>3</sup>, p < 0.01), ESR (36.3 ± 15.8 vs. 9.4 ± 3.3 mm, p < 0.001), TNF-α (52 ± 18.4 vs. 10.7 ± 2.8 pg/ml, p < 0.001) and IL-6 (6.3 ± 4 vs. 1.8 ± 0.4 pg/ml, p < 0.001). No differences in high-sensitivity CRP and IL-10 were noted between the ESKD and control groups. Serum IL-6 levels were the only parameter positively correlated with the values of the ZS score in ESKD patients (r = 0.34, p < 0.02). Conclusions: IL-6 may play a role in the pathogenesis of depression in patients with ESKD.
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