MON-157 SELF-ASSESSMENT OF DEPRESSION AND ANXIETY: CORRELATION WITH BIOLOGICAL MARKERS IN HEMODIALYSIS PATIENTS

Abstract

Patients in hemodialysis have higher prevalence of mood disorders compared to the general population. These may cause an increase in morbi-mortality, poor adherence to treatment, immunological and nutritional deregulation and decline in quality of life. The objective of this study was to correlate psychological scores and biological variables obtained in the last 3 months in patients with CKD-V. Cross-sectional study monocentric, in a dialysis center, in southern Brazil. The study included 30 patients, who were submitted to a socio-demographic interview and an application of validated questionnaires in the Portuguese language on Quality of life (SF-36), Beck Depression Inventory (BDI) and Beck Anxiety inventory (BAI). The independence index for daily life activity and functionality were evaluated by the Multidisciplinary team through the Katz and Karnofsky scores. The project was approved by Ethic and Research Committee (CEP/HED). Anonymity was respected and the ICF was signed. The oral questionnaires were applied by one of the members of the multidisciplinary team during the dialysis session. Male gender: 50%; mean age: 65 y.o. the average time in HD: 36 months (4-192 mo); Hypertension (60%) and diabetes (27%) were the most common comorbidities; Laboratory data (means): Albumin: 3.9; Hematocrit: 32.6 %; PTH: 320; Ca: 9.3; P: 5,7; K: 5,4. Adequacy of dialysis: KtV 1.51, URR 69.3%.interdialytic weight gain 2,900 g; Poor adherence to therapy (1 mssing session/trimester:) 16%; hospital recoveries (last 3 months) in 40% (mostly due to access problem); need for temporary access (AVF failure) was 23%; married:40%; lived alone only 2 (6%); higher level education: 20% (n = 6); living at their own homes: 93%; away from their professional activities: 70% (21/30). Health self-assessment and Dialysis self-assessment categories "good/optimal" were the answers for 57% and 77% of patients, respectively. Anxiety was reported by 33% (n = 10) and depression by 37% (n =11). These conditions coexisted in 40% (n = 6). Karnofski scores ranged from 30-90, the majority of patients were considered "partially-dependent" (n = 20). A Katz Index of Independence in Activities of Daily Living score 5-6 was present in 70% (full function or mild dependence). Low serum iron was associated with depression (ANOVA, p=0.001) but not with anxiety. Self-assessment in optimal health/good, high schooling, normal blood glucose levels had a good correlation with absence of depression (chi-square, p = 0.04; 0.04 and 0.03). We did not observe correlation between arterial blood pressure (higher or lower values) and anxiety or depression in this sample. BDI and BAI scores are effective diagnostic tools for depression and anxiety and had a good correlation with some clinical outcomes and biological variables among patients with terminal CKD undergoing hemodialysis.