C reactive protein and depressive symptoms in hemodialysis patients: A questionable association

• Published in: Hemodialysis international 2017-10, Vol.21 (4), p.542-548
• Main Authors: Chilcot, Joseph, Friedli, Karin, Guirguis, Ayman, Wellsted, David, Farrington, Ken, Davenport, Andrew
• Format: Article
• Language: English
• Subjects: Aged; BDI‐II; C reactive protein; C-Reactive Protein - metabolism; depression; Depression - blood; dialysis; Female; Humans; inflammation; Kidney Failure, Chronic - complications; Male; Middle Aged; PHQ‐9; Renal Dialysis - adverse effects; Renal Dialysis - methods; Renal Dialysis - statistics & numerical data
• ISSN: 1492-7535; 1542-4758
• DOI: 10.1111/hdi.12500

Introduction: Patients with advanced chronic kidney disease (CKD) on haemodialysis (HD) may have increased C reactive protein (CRP) values and depressive symptoms. There is debate about the strength and nature of previously reported associations. We investigated these issues in a cohort of patients on HD. Methods: We screened for depressive symptoms using two valadiated depression screening tools: the Beck Depression Inventory‐II (BDI‐II), Patient Health Questionnaire (PHQ‐9). Demographic and clinical correlates of depression symptoms were eveluated in adjusted linear and logistic regression models, which included extra renal comorbidity and high CRP (>5 mg/L). Findings: Three hundred and ninety‐six HD patients were studied; 63.1% male, mean age 63.1 ± 16.4 years, median CRP 6 (5–15) mg/L. Depression scores were similar in those with normal and high CRP (BDI‐II (9(5–17) vs. 11(6–20)) or PHQ (4(2–9) vs. 6(2–10)). In adjusted multivariable regression BDI‐II scores were associated with previous history of depression (β 10.8, P