Vitamins and Microelement Bioavailability in Different Stages of Chronic Kidney Disease
OBJECTIVE Depression is considered as the most common psychological problem in hemodialysis (HD) patients. As there is little evidence regarding the association of depression with serum selenium level as an antioxidant in these patients, the current survey investigates the possible relationship between depression and nutritional status including serum selenium levels. DESIGN Cross-sectional study. SETTING AND SUBJECTS A total of 110 HD patients and 40 healthy controls were enrolled in the study. The patients were in the age range of 18 to 85 years, who had been on hemodialysis for at least 3 months without any acute illness. MAIN OUTCOME MEASURE Beck Depression Inventory was used for assessing the severity of depression. Malnutrition was evaluated through subjective global assessment (SGA) and malnutrition inflammation score (MIS). Serum selenium levels and routine laboratory markers were measured from fasting samples. RESULTS Sixty-two percent of the patients had some degree of depression based on Beck Depression Inventory score. HD patients were considered to be selenium deficient after comparing the mean value of serum selenium between the patients and controls (P < .001). No significant difference was found in serum selenium levels between depressed HD patients and the rest of patients without depression. The mean level of SGA and MIS in the depressed patients was significantly higher than the rest of patients (P = .03 and P = .04, respectively). Also lower levels of hemoglobin and serum albumin were significantly seen in depressed patients compared with nondepressed ones (P = .004 and P = .04, respectively). CONCLUSIONS Although the HD patients in this study were selenium deficient, no significant association was found between depression and selenium. In addition, depression was more prevalent in malnourished HD patients with higher SGA and MIS scores and lower serum albumin and hemoglobin levels.