Abstract
Background and Aims
While kidney transplantation (Ktx) offers several advantages in terms of improved clinical outcomes and quality of life compared to dialysis modalities, depressive symptoms are still present in approximately 25% of patients, rates comparable to that of the hemodialysis population. Correlates of depressive symptoms include marital status, income, and kidney function, history of affective illness, malnutrition, and inflammation. The aim of this study was to evaluate possible correlations between nutritional status evaluated through body mass composition parameters, muscle strength and depression in kidney transplant recipients (KtR).
Method
115 KtR, 61 (53 %) men and 54 (47 %) women, aged 59.3 (range 25 - 83) years were included. For each patient data about duration after Ktx, duration of dialysis before Ktx, age, gender, body weight and height were collected and body mass index (BMI) was calculated. Tanita MC780 Multi Frequency segmental body composition analyser was used to measure content of body fat, muscle mass, and visceral fat each study subject measured in kilograms (kg) and percentage (%.) Peripheral muscle strength of KtR was measured by using a standardized handgrip dynamometry protocol. The Beck Depression Inventory-Second Edition (BDI-II) was used as an indicator of the severity of depression.
Results
Out of all 115 KtR patients, according BDI-II score 25 (21.7 %) were depressed; 15 (13 %) had mild, 6 (5.2 %) moderate and 4 (3.5 %) severe depression. Significantly negative correlations between BDI-II scores (higher score – more depressive symptoms) and muscle mass (kg and %) was found (R=-0.205, P=0.032), (R=-0.278, P=0.003), respectively. Therefore, significantly positive correlations between BDI-II scores (higher score – more depressive symptoms), fat mass (%) and age was found (R=-0.24, P=0.012), (R=-0.231, P=0.013), respectively. Those KtR patients with more depressive symptoms (higher BDI-II score) had statistically lower muscle strength (R=-0.205, P=0.032). Significantly correlation between duration after Ktx and duration of dialysis before Ktx with BDI-II score was not found.
Conclusion
Prevalence rates for depression in this study is similar with previous reports and results have shown that depressive KtR patients were older and had significantly lower muscle mass and muscle strength and significantly higher fat mass content. Possible explanation for this findings might be that depression in KtR is associated with unhealthy behaviours including lower activity levels and worse dietary habits, which may in turn impact body mass composition parameters and upon transplant-related outcomes. Efforts to detect and treat depression should be a priority if one is to improve treatment and dietary adherence, quality of life, and outcomes in KtR.
The Associations of Muscle Strength, Muscle Mass, and Adiposity With Clinical Outcomes and Quality of Life in Prevalent Kidney Transplant Recipients
