Akademik Veri Yönetim Sistemi
American Society of Nephrology Kidney Week 2023: Meeting Overview, Washington, Amerika Birleşik Devletleri, 2 - 04 Kasım 2023, ss.357
Background: Neuropsychiatric disorders, mainly cognitive decline, depression, and
anxiety, are more common in CKD patients. The association between iron deficiency
anemia (IDA) and cognitive decline is well-known for this population. For patients without CKD, IDA is associated with depression and anxiety. However, the link between
depression, anxiety, and IDA is not clear in subjects with non-dialysis-dependent CKD. In
this work, we aimed to evaluate the association above.
Methods: We selected a cohort of patients with stable stage 2-4 CKD and assessed
them with Beck’s depression inventory (BDI) and Beck’s anxiety inventory (BAI).
We excluded patients with acute kidney injury or decompensation, hematological/
solid malignancies, and those suffering from psychological trauma. A diagnosis
of schizophrenia, major depression, and bipolar disorder or using antidepressant/
antipsychotic drugs were reasons for exclusion. We also did not include those needing
EPO or those with other causes of anemia.
Results: Two hundred patients were included in the final analysis. 76 of 200 (38%)
patients were anemic. Patients with anemia were older and had worse GFR. BDI scores
were worse for patients with anemia. Furthermore, with a cut-off of eleven for BDI,
31,7% of patients in non-anemic and 51,4% of patients in anemic groups deserved further
evaluation for clinical depression. The difference was significant (p=0,007). Univariate
analysis did not reveal a relationship between BDI and hemoglobin, transferrin saturation,
and ferritin levels. A multivariate analysis was not undertaken due to the low number
of patients. A subgroup analysis of anemic patients also showed that patients who had
received iron, despite being still anemic, had lower BDI scores compared to those
with untreated anemia (p<0,001) BAI scores were similar between groups. In addition,
frequencies of minimal, mild, moderate, and severe anxiety were similar. However, in
subgroup analysis, patients who had received iron despite being still anemic had lower
BAI scores than those with untreated anemia.
Conclusions: Our work hints at a viable link between depression, anxiety, and IDA
in subjects with Stage 2-4 CKD. However, this study is observational and thus only can
generate a hypothesis. Prospectively designed studies on iron replacement may further
elaborate our understanding of these associations.