Association of uremic toxins and systemic inflammation with depression and anxiety among hemodialysis patients in Montenegro

ObjectiveThe purpose of this study was to examine the association between uremic toxins, inflammation, depression and anxiety among hemodialysis patients in Montenegro.MethodThe cross-sectional study included 88 patients undergoing hemodialysis. Depression symptoms were assessed by Patient Health Questionnaire (PHQ-9), and anxiety symptoms were measured by the Beck Anxiety Inventory (BAI). Standard laboratory methods were used to measure uremic toxins and systemic inflammation (C-reactive protein, Neutrophil-to-Lymphocyte Ratio [NLR] and Platelet-to-Lymphocyte Ratio [PLR]).ResultsClinically significant depression (PHQ-9 ≥ 10) and anxiety (BAI ≥16) were found in 55.7% and 27.2%, respectively. Logistic regression analyses revealed that serum urea, beta 2-microglobulin (B2M), and systemic inflammation (CRP, NLR, PLR) were significantly and independently associated with depressive symptoms, whereas serum urea, creatinine, uric acid, B2M, and systemic inflammation (CRP nad NLR) were associated with anxiety symptoms.ConclusionsDepressive symptoms and anxiety are common among hemodialysis patients in Montenegro, and are associated with increased levels of systematic inflammation, serum urea, and beta 2-microglobulin.