Rick Factors Of Sleep Quality And Depression In Maintenance Peritoneal Dialysis Patients

ObjectiveTo investigate the prevalence and associated factors of sleep quality and depression in peritoneal dialysis PatientsMethods1)Participants From June 2017 to March 2019,175 patients with chronic kidney disease who undergoing continuous ambulatory peritoneal dialysis at the First Affiliated Hospital of Anhui Medical University were collected2)Research methods?Collected basic information(name,gender,age,whether married,lone living,education level,primary disease,dialysis age),laboratory measurements(including hemoglobin,serum albumin,renal function,blood electrolytes,blood lipids,intact parathyroid hormone,hypersensitivity creative protein,25-hydroxy vitamin D,etc.)?Under the guidance of the researchers,each patient completed the Baker Depression Scale Score-?(BDI-?),the SAS Anxiety Scale Score,and the Pittsburgh Sleep Quality Index(PSQI).?According to the patients' PSQI,they were divided into better sleep group(PSQI?5)and sleep disorder group(PSQI>5).Compare the general information and laboratory tests between the two groups.Spearman correlation analysis was used to analyze the relationship between PSQI total score and various parameters,and multiple linear regression analysis was used to analyze the independent risk factors of PSQI? According to the patients' PSQI,they were divided into non-depressive group(BDI-?<14)and depression group(BDI-?<14).Spearman rank correlation analysis was used to analyze the relationship between depression and various parameters,and Logistic regression analysis was used to analyze risk factors of depression?Statistical processing using SPSS 25.0 statistical.P<0.05 was statistically significant.Results?The prevalence of sleep disorders,depression,and anxiety were 49.14%,39.43%,and 38.29%,respectively.?PSQI(11.690 ± 3.692),Subjective sleep quality(1.820 ± 0.815),sleep latency(1.930±1.020),sleep duration(1.840 ± 1.039),habitual sleep efficiency(1.790 ±1.420),sleep disturbances(1.660 ± 0.710),use of medication for sleep(0.330 ±0.824),Daytime Dysfunction(1.810 ± 0.973),iPTH(613.339 ± 464.573),Hypersensitivity-CRP(3.596±7.216),Proportion of Depression(?2=27.966),and Anxiety(?2=21.989)of sleep disorder group were higher than the better sleep group.The hemoglobin(90.730 ± 16.284),BMI(21.124 ± 2.788),and total Kt/V(1.319 ±0.957)were lower than that in the better sleep group.? PSQI is negatively correlated with hemoglobin,total Kt/V,positively correlated with iPTH,BDI-?,and SAS points.(R values=-0.332,-1.890,0.363,0.450,0.354).Multiple linear regression analysis showed that iPTH and BDI-? scores were independent risk factors for PSQI.?PSQI of the depressed group(9.18±6.758)was significantly higher than that of the non-depressed group(4.710 ± 3.973).Subjective sleep quality(1.69 ± 0.779),sleep latency(1.850 ± 0.911),sleep duration(1.600 ± 1.180),habitual sleep efficiency(1.56 ± 1.561),and sleep disturbances(1.530 ± 0.879),daytime dysfunction points(1.670 ± 1.072),percentage of anxiety(?2=9.119,P=0.003),and percentage of sleep disorders(?2=25.298,P=0.000)were significantly higher than those in the non-depressed group.Hemoglobin(87.930 ± 17.978)and serum albumin(35.318 ±6.176)were significantly lower than those in the non-depressed group.? Depression was positively correlated with PSQI score(r=0.450)and SAS score(r=0.353),negative correlation with hemoglobin(r=-0.357),education level(r=-0.256)and serum albumin level(r=-0.220).Hemoglobin(P<0.05,OR value=0.971,95%CI=0.947?0.996)and serum albumin(P<0.05,OR value=0.874,95%CI=0.785?0.973)are independent protective factors of depression.Low education level(P<0.05,OR value=4.570,95%CI=1.596?13.097),PSQI score(P<0.05,OR value=1.177,95%CI=1.069?1.297),and SAS score(P<0.05,OR Value=1.060,95%CI=1.020 to 1.101)are independent risk factors for depressionConclusion? Sleep disorders and depressive symptoms are common in patients with maintenance peritoneal dialysis?Sleep disorders are related to hemoglobin levels,dialysis adequacy,parathyroid function,and depression levels.Parathyroid hormone levels and depression scores are independent risk factors for sleep disorders? Depression is related to hemoglobin levels,albumin levels,sleep quality,anxiety and education.Hemoglobin and serum albumin levels are protective factors for depression.Patients with low education level,combined with anemia,hypoproteinemia,and sleep disorders should be followed up to assess their mental status.