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

          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
            root8848@sina.com
            Journal
            BMC Psychiatry
            BMC Psychiatry
            BMC Psychiatry
            BioMed Central (London )
            1471-244X
            5 March 2024
            5 March 2024
            2024
            : 24
            : 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
            5576
            10.1186/s12888-024-05576-8
            10913615
            38443831
            20aecce1-c796-4466-b6ef-c1c44050d8c1
            © The Author(s) 2024

            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
            : 30 July 2023
            : 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
            Categories
            Research
            Custom metadata
            © BioMed Central Ltd., part of Springer Nature 2024

            Clinical Psychology & Psychiatry
            cross-sectional study,depressive symptoms,handgrip strength,hemodialysis

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