The Preliminary Study of the Effects of Antidepressant Treatment on the Depressive Symptoms and the Nutritional Indexes in the Patients with Chronic Rena Failure on Maintenance Hemodialysis / 신경정신의학

ABSTRACT

OBJECTIVES: Depression is a common affective problem in patients with chronic medical illness. It has been well known that depression gives negative influence to medical outcome in patients with chronic renal failure (CRF). The purpose of this study is to reveal the effects of antidepressant treatment on depressive symptoms and nutritional indexes. We hope that this study could be a help to make a new model in the treatment of patients with CRF. METHODS: For this study, 30 depressive patients with CRF on maintenance hemodialysis were included. As affective variables, Hamilton Depression Rating Scale (HDS) and Zung's Self-Rating Depression Scale (SDS) were used. Medical outcomes were assessed with the following nutritional parameters Kt/V, normalized protein catabolic rate (nPCR), serum albumin concentration, BUN, intracelluar fluid(ICF), extracellular fluid (ECF), lean body mass, fat mass, percent body fat, waisthip ratio (WHR), and body mass index(BMI). Paroxetine, one of the SSRI classes, was administered as antidepressant for 8 weeks. For statistical analysis paired t-test was used for each variables. RESULTS: The prevalences of depression were 75% from HDS and 80% from SDS (N=40). The mean+/-SD of HDS and SDS score were 12.35+/-7.45 and 59.43+/-11.89 respectively. HDS score significantly decreased (p< 05) after antidepressant treatment for 8 weeks. There was a significant increase (<.05) in such nutritional parameters as nPCR, serum albumin concentration, BUN, ICF, ECF, and WHR. CONCLUSION: Both nutritional indexes and depressive symptoms improved after 8 weeks of antidepressant treatment. We suggest that improvement of depressive symptoms should contribute to improved nutritional indexes. Long-term follow up and placebo-controlled double blind study are firmly required to confirm the results of this study.