Association between handgrip strength and depressive symptoms in patients undergoing hemodialysis: a cross-sectional study from a single Chinese center

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Abstract

Background

The relationship between handgrip strength (HGS) and depression in patients undergoing hemodialysis (HD) was unknown. Therefore, we aimed to clarify this association in a cohort of patients.

Methods

HGS was used as a representative indicator of muscle strength and was measured with a handheld dynamometer. Depressive symptoms were assessed with the self-reported Patient Health Questionnaire-9. A multivariable logistic regression model and restricted cubic spline analysis were used to assess the relationship between HGS and depression.

Results

The prevalence of depression in our study was 34% in 568 Chinese patients undergoing HD. Compared with patients in the lowest tertiles of absolute and weighted HGS, patients in the highest tertiles of HGS had an approximately 59% lower [odds ratio (OR) = 0.41, 95% confidence interval (CI) = 0.24–0.68; OR = 0.41, 95%CI = (0.24–0.69)] prevalence of depressive symptoms after multivariate adjustments. Besides, the risk of depression in hemodialysis patients decreased by 33% (OR = 0.67, 95%CI = 0.53–0.85) and 32% (OR = 0.68, 95%CI = 0.54–0.85) for each standard deviation increase in absolute HGS and weighted HGS, respectively. The prevalence of depressive symptoms decreased with both increasing absolute HGS and weighted HGS after multivariate adjustments ( p for trend < 0.05). Furthermore, a linear dose-response relationship was observed between absolute HGS and weighted HGS and the prevalence of depressive symptoms ( p _nonlinearity>0.05).

Conclusions

This study suggests that lower handgrip strength, a simple and modifiable parameter, is associated with a higher prevalence of depression in Chinese patients undergoing HD. Considering that depression is often unrecognized or underdiagnosed in HD patients, lowered muscle strength should be an important indicator and incentive for medical staff to screen for depression.

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Most cited references 1

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Association between depression and hemodialysis in patients with chronic kidney disease.

Aleksandra Ćwiek, Marcelina Czok, Bartłomiej Kurczab … (2017)

Depression is the most common and serious psychiatric disorder that affects patients with chronic kidney disease and end-stage renal disease, and, has a significant impact on their quality of life. The aim of this study was to investigate and compare prevalence rates of depression among hemodialyzed patients, and non-dialyzed patients with a glomerular filtration rate<30 ml/min/1.73m2 receiving conservative treatment or following kidney transplantation. A total of 50 hemodialyzed and 50 non-dialyzed patients with stage 4/5 of CKD was assessed using the following questionnaires: Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D), The Satisfaction with Life Scale (SWLS), The Acceptance of Illness Scale (AIS), and The Life Orientation Test-Revised (LOT-R). The use of steroids and immunosuppressant drugs was also investigated. Symptoms of depression and anxiety were present in both groups, however the proportion of persons with mild or severe depression was higher among dialyzed patients. The AIS, LOT-R and SWLS scores were very similar in both the groups. The patients using steroids and/or immunosuppressant drugs were more prone to develop mild or severe depression according to the HAM-D scores. The results indicated a high prevalence of depression and anxiety among patients with CKD. Furthermore, the fraction of patients with depression is greater among hemodialyzed patients. This indicates the importance of monitoring the mental state of the patients as well as the necessity of providing timely psychological care for patients with CKD.

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Author and article information

Contributors

Shu-Xin Liu: root8848@sina.com

Journal

Journal ID (nlm-ta): BMC Psychiatry

Journal ID (iso-abbrev): BMC Psychiatry

Title: BMC Psychiatry

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-244X

Publication date (Electronic): 5 March 2024

Publication date PMC-release: 5 March 2024

Publication date Collection: 2024

Volume: 24

Electronic Location Identifier: 182

Affiliations

[1 ]Department of Nephrology, Dalian Municipal Central Hospital, ( https://ror.org/01n6v0a11) No.826, Xinan Road, Dalian, Liaoning 116033 P. R. China

[2 ]Dalian Key Laboratory of Intelligent Blood Purification, Dalian Municipal Central Hospital, ( https://ror.org/01n6v0a11) Dalian, China

[3 ]GRID grid.30055.33, ISNI 0000 0000 9247 7930, Faculty of Medicine, , Dalian University of Technology, ; Dalian, China

[4 ]GRID grid.412467.2, ISNI 0000 0004 1806 3501, Department of Clinical Epidemiology, , Shengjing Hospital of China Medical University, ; Shenyang, China

Article

Publisher ID: 5576

DOI: 10.1186/s12888-024-05576-8

PMC ID: 10913615

PubMed ID: 38443831

SO-VID: 20aecce1-c796-4466-b6ef-c1c44050d8c1

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 30 July 2023

Date accepted : 1 February 2024

Funding

Funded by: the Dalian Key Medical Specialty Dengfeng Project

Award ID: 2022ZZ236

Award ID: 2022ZZ231

Funded by: Dalian Medical Science Research Program

Award ID: 2211008

Funded by: Dalian Science and Technology Talent Innovation Support Policy Implementation Plan Project

Award ID: 2023RQ037

Funded by: Applied Basic Research Project of Liaoning Province, China

Award ID: 2023JH2/101300091

Custom metadata

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: cross-sectional study,depressive symptoms,handgrip strength,hemodialysis

Data availability:

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: cross-sectional study, depressive symptoms, handgrip strength, hemodialysis

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