HIV-associated disparities in interdialytic weight gain and depressive symptomatology among male hemodialysis patients: A comparative analysis of fluid management adherence

Chronic kidney disease is common among people living with human immunodeficiency viruses (PLWH). Effective volume management is crucial for patients undergoing hemodialysis. This study analyzed the clinical characteristics and treatment status of male PLWH on hemodialysis, investigated differences in volume control compared to non-HIV-infected male patients, and further investigated the association between fluid management adherence and depressive symptoms in this population. This analytical study included 37 non-HIV-infected and 20 PLWH male hemodialysis patients. Baseline data and health indicators, including hematological parameters, electrolyte levels, lipid profiles, inflammatory markers, Kt/V, and urea reduction ratio values, were assessed. Interdialytic weight gain (IDWG) was measured over 1-month to determine the mean IDWG and its percentage relative to the dry body weight. These patients were then invited to complete the hospital anxiety and depression scale (HADS). There were no significant differences in erythrocyte, albumin, blood glucose, lipid, urea, creatinine, uric acid, potassium, parathyroid hormone, hypersensitive C-reactive protein, and dialysis adequacy between the 2 groups. PLWH on hemodialysis had lower blood calcium levels (2.1 ± 0.2 vs 2.2 ± 0.1, P < .05) and higher phosphorus levels (2.2 ± 0.7 vs 1.8 ± 0.5, P < .05). The mean IDWG for non-HIV-infected patients was 2.1 ± 0.8 kg, while for PLWH it was 3.1 ± 0.9 kg (P < .001). As a percentage of dry body weight, mean IDWG was 4.9 ± 1.5% for PLWH compared to 3.3 ± 1.1% for non-HIV-infected patients (P < .001). PLWH receiving hemodialysis demonstrated significantly higher HADS-D scores (6.7 ± 2.6 vs 4.2 ± 2.4, P < .01) and total HADS scores (10.7 ± 5.3 vs 6.8 ± 3.6, P < .01). Patients with IDWG exceeding 4% of dry body weight demonstrated significantly higher HADS-D scores (6.6 ± 2.5 vs 3.9 ± 2.4, P < .01) and total HADS scores (10.1 ± 4.0 vs 6.7 ± 4.5, P < .01) compared to those with lower fluid gains. PLWH undergoing hemodialysis exhibited poorer weight management and more severe depressive symptoms. Depressive symptomatology may adversely influence adherence to fluid management in patients undergoing hemodialysis.