Depression In Pre And Post Hemodialysis First Time In Patients With Uremia And Related Factors

ObjectiveTo investigate the incidence and related factors of depressive disorder in patients with uremia before and after their first hemodialysis.screen the influence related indexes for depression,study,provide a certain objectice basis for early detection and prevention of disease.Through this study to improve medical staff emphasis on patients with mental disorders,it is the purpose of the treatment of giving appropriate psychological intervention,helping to overcome the psychological obstacles,promoting the physical and mental health,.MethodsThe 177 patients with uremia before and after their first hemodialysis and 138 out-patient healthy persons as the object of the study.Then Hamilton Depression Scale was measured,and biochemical indexes and general population data were collected.The related factors were analyzed.Results(1)The incidence of depressive disorder was 35.0% for one week before first hemodialysis,and the incidence was 11.9% for one week after first hemodialysis.The score of depression scale was significantly lower for one week after first hemodialysis(t=16.267,P <0.001).(2)The serum creatinine,urea nitrogen,serum kalium and serum phosphate levels were significantly lower(creatinine: t=21.114,P<0.001;urea nitrogen: t=16.330,P<0.001;serum kalium: t=5.976,P< 0.001;serum phosphate: t=6.563,P<0.001)for patients after one day of the first time hemodialysis.The depression scale of uremic patients with comorbidity(15.82±8.46)was significantly higher than those without complications(12.36±7.65)in one week before hemodialysis,and there was statistic significant difference(t=-2.528,P= 0.013);and in normal control,no depression and depression between the three groups of blood biochemical indexes of blood glucose,creatinine,urea nitrogen,total cholesterol,albumin at different levels,the difference were statistically significant(blood glucose: F=25.941,P< 0.001;creatinine: F=557.961,P< 0.001;urea nitrogen: F=252.691,P< 0.001;total cholesterol: F=33.559,P< 0.001;albumin: F=51.009,P< 0.001);(3)Spearman correlation analysis showed that serum blood glucose,creatinine,urea nitrogen and Hamilton depression scale was positively correlated(P< 0.001),blood total cholesterol,albumin level and Hamilton depression scale was negatively correlated(P< 0.001).Conclusions(1)The incidence of depressive disorder for one week before first hemodialysis was significantly higher than that of normal people,and the incidence of depression symptoms after dialysis was decreased.(2)The related factors about depression had comorbidities,blood glucose,creatinine,urea nitrogen,total cholesterol and albumin.(3)The incidence of depressive disorder was decreased for uremic patients before their first hemodialysis,and creatinine,the levels of urea nitrogen,serum kalium and serum phosphate level were decreased.(4)When patients need maintennace hemodialysis treatment,medical workers not only need to treat patients with somatic symptoms,but also should be more positive assessment of the patient's mental state,give corresponding intervention measures actively,help patients to establish a good attitude,overcome the psychological obstacles,achive the purpose to reduce the incidence of depression.