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Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study

Received: 5 May 2020     Accepted: 15 June 2020     Published: 29 June 2020
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Abstract

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.

Published in International Journal of Biomedical Engineering and Clinical Science (Volume 6, Issue 2)
DOI 10.11648/j.ijbecs.20200602.14
Page(s) 48-54
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Depressive Symptoms, Hemodialysis, Iron Management

References
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  • APA Style

    Yoshihiro Tsuji, Naoki Suzuki, Yasumasa Hitomi, Yuko Mizuno-Matsumoto, Toshiko Tokoro, et al. (2020). Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study. International Journal of Biomedical Engineering and Clinical Science, 6(2), 48-54. https://doi.org/10.11648/j.ijbecs.20200602.14

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    ACS Style

    Yoshihiro Tsuji; Naoki Suzuki; Yasumasa Hitomi; Yuko Mizuno-Matsumoto; Toshiko Tokoro, et al. Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study. Int. J. Biomed. Eng. Clin. Sci. 2020, 6(2), 48-54. doi: 10.11648/j.ijbecs.20200602.14

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    AMA Style

    Yoshihiro Tsuji, Naoki Suzuki, Yasumasa Hitomi, Yuko Mizuno-Matsumoto, Toshiko Tokoro, et al. Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study. Int J Biomed Eng Clin Sci. 2020;6(2):48-54. doi: 10.11648/j.ijbecs.20200602.14

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  • @article{10.11648/j.ijbecs.20200602.14,
      author = {Yoshihiro Tsuji and Naoki Suzuki and Yasumasa Hitomi and Yuko Mizuno-Matsumoto and Toshiko Tokoro and Masato Nishimura},
      title = {Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study},
      journal = {International Journal of Biomedical Engineering and Clinical Science},
      volume = {6},
      number = {2},
      pages = {48-54},
      doi = {10.11648/j.ijbecs.20200602.14},
      url = {https://doi.org/10.11648/j.ijbecs.20200602.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbecs.20200602.14},
      abstract = {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.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Association of Depressive Symptoms with Iron Management in Patients on Maintenance Hemodialysis: A Cross-sectional Study
    AU  - Yoshihiro Tsuji
    AU  - Naoki Suzuki
    AU  - Yasumasa Hitomi
    AU  - Yuko Mizuno-Matsumoto
    AU  - Toshiko Tokoro
    AU  - Masato Nishimura
    Y1  - 2020/06/29
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ijbecs.20200602.14
    DO  - 10.11648/j.ijbecs.20200602.14
    T2  - International Journal of Biomedical Engineering and Clinical Science
    JF  - International Journal of Biomedical Engineering and Clinical Science
    JO  - International Journal of Biomedical Engineering and Clinical Science
    SP  - 48
    EP  - 54
    PB  - Science Publishing Group
    SN  - 2472-1301
    UR  - https://doi.org/10.11648/j.ijbecs.20200602.14
    AB  - 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.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • Department of Medical Engineering, Faculty of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan

  • Department of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan

  • Department of Clinical Engineering, Tojinkai Hospital, Kyoto, Japan

  • Graduate School of Applied Informatics, University of Hyogo, Kobe, Japan

  • Department of Nephrology, Tojinkai Satellite Clinic, Kyoto, Japan

  • Cardiovascular Division, Tojinkai Satellite Clinic, Kyoto, Japan

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