Evaluation of the relationship between vitamin D level, nutritional status and depression in hemodialysis patients

This study was carried out on 150 patients with chronic renal failure (CRF), 55 female and 95 male, aged 19-64 years in hemodialysis at Başkent University Hospital Yenikent Dialysis and Ümitköy Dialysis Center. In this study, a questionnaire was used to determine the demographic characteristics of individuals. In order to determine the nutritional status of individuals and energy -nutrient consumption, the three-day food consumption record, and anthropometric measurements were taken by the researcher. Serum 25 (OH)D vitamin level of the patients participating in the study was analyzed and recorded in Başkent University Ankara Hospital Biochemistry Laboratory. Physical Activity Assessment Form was used to determine the physical activity levels of the patients, and the Beck Depression Inventory was used to determine mood and tendency to depression. Malnutrition status was also determined by Malnutrition Inflammation Score (MİS). The average age of the patients participating in the research is 49.9±12.20 years. It has been determined that patients are exposed to an average of 0.84 ± 0.81 hours of sunlight per day. The duration of CRF patients to be dialysis was determined as 9.8±8.00 years, and the duration of the CRF diet was determined to be 9.2±8.00 years. It was found that 13.3% of the patients had closed clothing and 24.7% had regular exercise. The mean of The Basal Metabolism Rate was 1631.32±208.39 kcal in male patients and 1366.19±173.85 kcal in women. The mean factor of physical activity was 1.35±0.05. The average daily energy expenditure was 2207.26±272.62 kcal in male patients and 1835.96±242.42 kcal in female patients. Serum vitamin D level average of male patients was 18.8±12.37 ng/mL, women were 19.2±20.14 ng / mL, and serum vitamin D level average of total patients was 18.98±15.61 ng/mL. The mean serum vitamin D of 71 patients who took vitamin D supplements was found to be 20.2±13.68 ng/mL, and the serum vitamin D mean of 79 patients who did not take supplements was 17.9±17.16 ng/mL. Serum vitamin D levels were missing in 57.7% of patients receiving vitamin D supplementation, 16.9% were insufficient, and 25.4% were normal. Patients who did not take vitamin D supplementation 70.9% were found to be deficient in serum vitamin D levels, 16.5% were insufficient and 12.7% were normal. Vitamin D deficiency was determined in 64.7% of total patients, 63.6% of women and 65.3% of men. The mean Malnutrition Inflammation Score of the patients was 8.5±2.50. The mean MIS score of the patients with serum vitamin D deficiency level was 8.8±2.50, 8.3±2.20 for insufficiency levels and 8.0±2.50 for normal patients. The mean Beck depression scale score of the patients with serum vitamin D deficiency level was 10.5±6.40, and 8.0±5.50 for insufficiency level and 8.5±5.00 for normal level patients. The negative correlation between the Beck depression scale and serum vitamin D level was found to be statistically significant (p <0.05). According to the results of this study, the Beck depression score was found to be significantly higher as the serum vitamin D level decreased. For this reason, monitoring the serum vitamin D levels in patients with renal insufficiency and supplementing them in case of insufficiency may contribute to improving the mood of the patients. Keywords: Chronic Kidney Disease, Hemodialysis, Vitamin D deficiency, Depression