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Nefrologia. 2002;22(3):244-52.

[Poor adherence to diet in hemodialysis: role of anxiety and depression symptoms].

[Article in Spanish]

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Universidad Peruana Cayetano Heredia, Lima, Perú.



To determine whether symptoms of anxiety or depression are factors associated with poor compliance of fluid restriction and dietary selection in chronic renal failure patients in hemodialysis.


A cross-sectorial, descriptive, comparative and correlation study was designed between january and march of 2000, patients were selected in 3 hemodialysis centers of Social Security in Lima with Karnofsky index > 80, without an acute failure of treatment or default from therapy in the last 3 months. Depressive symptoms were evaluated with Beck Depression Inventory and Anxiety Symptoms with the Zung Scale. Poor compliance with fluid restriction was defined as an interdialytic weight gain > or = 2.5 kg and dietary restriction as a level of predialysis serum potassium > or = 6 meq/L. The evaluation of risk factors was made with a simple and multiple logistic regression analysis.


Eighty eight patients were selected, 47 (53.4%) were men, the average values of age, time on dialysis, level of creatinine and hemoglobin were respectively 55.9 +/- 15.8 years old, 48.8 +/- 38.8 months, 8.5 +/- 1.9 mg/dl and 7.7 +/- 1.4 g/dl. The number of patients with adequacy of dialysis, depressive symptoms, anxiety symptoms, poor compliance with fluid restriction and dietary selection were respectively 50 (62.5%), 54 (61.4%), 46 (52.3%), 47 (53.4%) and 31 (35.2%). The multiple logistic regression analysis showed that depressive symptoms are the only factor associated with poor compliance with fluid restriction (OR = 2.7, p = 0.002) and dietary selection (OR = 2.5, p = 0.0067). Depressive symptoms and them severity had a positive correlation with poor compliance.


Depressive symptoms and its severity is associated with a higher interdialitytic weight gain and higher predialysis serum potassium in hemodialysis patients. Early diagnosis and therapeutic intervention might benefit these patients.

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