The Relationship Between Echocardiographic Findings, Cognitive Functions And Depression In Dialysis Patients

Yıl 2026, Cilt: 17 Sayı: 1 , 27 - 38 , 20.04.2026

Muammer Avcı , Ela Güven Avci , Fatih Aksoy , Barış Afşar

https://doi.org/10.22312/sdusbed.1633360

https://izlik.org/JA98BH53KP

Öz

İntroduction: Quality of life is associated with increased morbidity and mortality. İt is mainly determined with depression and cognitive functions. Cognitive decline is exacerbated by both microvascular and macrovascular disease due to cerebrovascular damage even in early stages of CRF. Given the close relationship between cardiovascular disease(CVD) and chronic renal failure(CRF), this study aimed to investigate the relationship between depression and cognitive dysfunction and cardiac functions.
Methods: The sample included 55 patients receiving dialysis, 37 undergoing hemodialysis and 18 undergoing peritoneal dialysis. The Beck Depression Inventory(BDI),Mini-Mental State Examination(MMSE) and echocardiography were administered to participants.
Results: No significant correlation was found between the MMSE score and BDI with echocardiographic parameters in the total sample. Subgroup of 37 hemodialysis patients, a weak positive correlation was observed between the BDI score.
Conclusion: This study demonstrated association between depression and cardiovascular events and no correlation between cognitive function and echocardiographic parameters.

Anahtar Kelimeler

: dialysis and depression , dialysis and cognitive functions , dialysis and echocardiographic findings , Echocardiographic findings and cognitive functions

Kaynakça

• 1. Kamel, R.A.E., M. Fouad, and T.M. Goda, Anxiety and depression among hemodialysis patients in Egypt. Zagazig University Medical Journal, 2022. 28(3): p. 594-604.
• 2. Santos, D.G.M.d., et al., Association between frailty and depression among hemodialysis patients: a cross-sectional study. Sao Paulo Medical Journal, 2022. 140(3): p. 406-411.
• 3. Wu, Y.-H., Y.-J. Hsu, and W.-C. Tzeng, Correlation between physical activity and psychological distress in patients receiving hemodialysis with comorbidities: A cross-sectional study. International Journal of Environmental Research and Public Health, 2022. 19(7): p. 3972.
• 4. Matsushita, K., et al., Epidemiology and risk of cardiovascular disease in populations with chronic kidney disease. Nature Reviews Nephrology, 2022. 18(11): p. 696-707.
• 5. Tian, X., et al., Cognitive dysfunction and its risk factors in patients undergoing maintenance hemodialysis. Neuropsychiatric Disease and Treatment, 2022: p. 2759-2769.
• 6. Ak, R., et al., Kronik Böbrek Hastalığında Bilişsel Fonksiyon Bozukluğu Diyaliz Modalitesinin Etkisi. The Turkish Nephrology, Dialysis and Transplantation Journal, 2015. 24(3): p. 283-293.
• 7. Kupske, J.W., M.M. Krug, and R.d.R. Krug, Cognitive Function of Patients with Chronic Renal Insufficiency in Hemodialysis: A Systematic Review. Psicologia: Teoria e Pesquisa, 2023. 39: p. e39202.
• 8. Ricardo, A.C., et al., Validation of the Beck Depression Inventory in US Hispanic Patients with Chronic Kidney Disease. Clinical Journal of the American Society of Nephrology, 2024: p. 10.2215.
• 9. Hisli, N., Beck depresyon envanterinin universite ogrencileri icin gecerliligi, guvenilirligi.(A reliability and validity study of Beck Depression Inventory in a university student sample). J. Psychol., 1989. 7: p. 3-13.
• 10. Henry, W.L., et al., Report of the American Society of Echocardiography Committee on nomenclature and standards in two-dimensional echocardiography. Circulation, 1980. 62(2): p. 212-217.
• 11. Sahn, D.J., et al., Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation, 1978. 58(6): p. 1072-1083.
• 12. Krittanawong C, Maitra NS, Qadeer YK, Wang Z, Fogg S, Storch EA, et al. Association of depression and cardiovascular disease. The American journal of medicine. 2023;136(9):881-95.
• 13 .Alshelleh S, Alhawari H, Alhouri A, Abu-Hussein B, Oweis A. Level of depression and anxiety on quality of life among patients undergoing hemodialysis. International journal of general medicine. 2023:1783-95.
• 14. Yonata A, Islamy N, Taruna A, Pura L. Factors affecting quality of life in hemodialysis patients. International Journal of General Medicine. 2022;15:7173.
• 15. Beurel E, Toups M, Nemeroff CB. The bidirectional relationship of depression and inflammation: double trouble. Neuron. 2020;107(2):234-56.
• 16. Lefrère A, Burtey S, Bobot S, Belzeaux R, Bobot M. Depression in chronic kidney disease: Particularities, specific mechanisms and therapeutic considerations, a narrative review. Behavioural brain research. 2025:115467.
• 17. Vogelzangs N, Seldenrijk A, Beekman AT, van Hout HP, de Jonge P, Penninx BW. Cardiovascular disease in persons with depressive and anxiety disorders. Journal of affective disorders. 2010;125(1-3):241-8.
• 18. Zeng J, Qiu Y, Yang C, Fan X, Zhou X, Zhang C, et al. Cardiovascular diseases and depression: A meta-analysis and Mendelian randomization analysis. Molecular psychiatry. 2025:1-13.
• 19. Meng R, Yu C, Liu N, He M, Lv J, Guo Y, et al. Association of depression with all-cause and cardiovascular disease mortality among adults in China. JAMA network open. 2020;3(2):e1921043-e.
• 20. Xu L, Zhai X, Shi D, Zhang Y. Depression and coronary heart disease: mechanisms, interventions, and treatments. Frontiers in Psychiatry. 2024;15:1328048.
• 21. Vaccarino V, Bremner JD. Stress and cardiovascular disease: an update. Nature Reviews Cardiology. 2024;21(9):603-16.
• 22. Zheng X, Wu W, Shen S. Prospective bidirectional associations between depression and chronic kidney diseases. Scientific Reports. 2022;12(1):10903.
• 23. Yang Y, Li X, Chen S, Xiao M, Liu Z, Li J, et al. Mechanism and therapeutic strategies of depression after myocardial infarction. Psychopharmacology. 2021;238(6):1401-15.
• 24. Kursat S, Colak HB, Toraman A, Ekmekci C, Tekce H, Alici T. The relationship between depression–malnutrition and echocardiographic-blood pressure parameters in chronic hemodialysis patients. International urology and nephrology. 2008;40:793-9.
• 25. Cheriex E, Leunissen K, Janssen J, Mooy J, Van Hooff J. Echography of the inferior vena cava is a simple and reliable tool for estimation of ‘dry weight’in haemodialysis patients. Nephrology Dialysis Transplantation. 1989;4(6):563-8.
• 26. Koc M, Toprak A, Tezcan H, Bihorac A, Akoglu E, Ozener IC. Uncontrolled hypertension due to volume overload contributes to higher left ventricular mass index in CAPD patients. Nephrology Dialysis Transplantation. 2002;17(9):1661-6.
• 27. Çelikdelen, S.Ö., THE EFFECT OF VOLUME STATUS ON QUALITY OF LIFE, ANXIETY, DEPRESSION AND SLEEP QUALITY IN HEMODIALYSIS PATIENTS. Medical Journal of Süleyman Demirel University, 2024. 31(1): p. 71-79.
• 28. Kim, Y.K., et al., Relationship between the course of depression symptoms and the left ventricular mass index and left ventricular filling pressure in chronic haemodialysis patients. Nephrology, 2011. 16(2): p. 180-186.
• 29. Kurella, M., et al., Cognitive impairment in chronic kidney disease. Journal of the American Geriatrics Society, 2004. 52(11): p. 1863-1869.
• 30. McIntyre, C.W. and A. Jain, Dialysis and cognitive impairment. Nature Reviews Nephrology, 2025: p. 1-12.
• 31. Jonsson P, Stegmayr C, Stegmayr B, Forsberg U. Venous chambers in clinical use for hemodialysis have limited capacity to eliminate microbubbles from entering the return bloodline: An in vitro study. Artificial Organs. 2023;47(6):961-70.
• 32. Westphalen H, Saadati S, Eduok U, Abdelrasoul A, Shoker A, Choi P, et al. Case studies of clinical hemodialysis membranes: Influences of membrane morphology and biocompatibility on uremic blood-membrane interactions and inflammatory biomarkers. Scientific reports. 2020;10(1):14808.
• 33. Nakatani TeaSciihpAJN, 86–90 (2003)., Naganuma T, Uchida J, Masuda C, Wada S, Sugimura T, et al. Silent cerebral infarction in hemodialysis patients. American journal of nephrology. 2003;23(2):86-90.
• 34. Anazodo UC, Wong DY, Théberge J, Dacey M, Gomes J, Penny JD, et al. Hemodialysis-related acute brain injury demonstrated by application of intradialytic magnetic resonance imaging and spectroscopy. Journal of the American Society of Nephrology. 2023;34(6):1090-104.
• 35. Moist LM, McIntyre CW. Cerebral ischemia and cognitive dysfunction in patients on dialysis. Clinical Journal of the American Society of Nephrology. 2019;14(6):914-6.
• 36. Wolfgram DF. Intradialytic cerebral hypoperfusion as mechanism for cognitive impairment in patients on hemodialysis. Journal of the American Society of Nephrology. 2019;30(11):2052-8.
• 37. Slessarev M, Mahmoud O, Albakr R, Dorie J, Tamasi T, McIntyre CW. Hemodialysis patients have impaired cerebrovascular reactivity to CO2 compared to chronic kidney disease patients and healthy controls: A pilot study. Kidney International Reports. 2021;6(7):1868-77.
• 38 Vanderlinden J, Wong DY, Chiu M, McIntyre CW, Jain A. Peritoneal Dialysis Patients Exhibit Quantifiable Neurocognitive Impairment but Not Acute Ischemic Brain Injury: A Magnetic Resonance Spectroscopy and Diffusion Tensor Imaging Study: SA-PO666. Journal of the American Society of Nephrology. 2023;34(11S):913.
• 39. Andrews TD, Day GS, Irani SR, Kanekiyo T, Hickson LJ. Uremic Toxins, Chronic Kidney Disease, and Cognitive Dysfunction. Journal of the American Society of Nephrology. 2025:10.1681.
• 40. Ghoshal S, O’Connell N, Tegeler C, Freedman BI. Cerebral hemodynamics in peritoneal dialysis versus intermittent hemodialysis: A transcranial Doppler pilot study. Peritoneal Dialysis International. 2021;41(4):417-.
• 41. Mantle D. Oxidative stress in peritoneal dialysis: the role of antioxidant supplementation. Journal of Kidney Care. 2024;9(6):281-4.
• 42. Massussi M, Bellicini MG, Adamo M, Pilotto A, Metra M, Padovani A, et al. Connecting the dots: A narrative review of the relationship between heart failure and cognitive impairment. ESC heart failure. 2025;12(2):1119-31.
• 43. Ye S, Huynh Q, Potter EL. Cognitive dysfunction in heart failure: pathophysiology and implications for patient management. Current Heart Failure Reports. 2022;19(5):303-15.
• 44. Loffredo L, Ettorre E, Zicari AM, Inghilleri M, Nocella C, Perri L, et al. Oxidative stress and gut‐derived lipopolysaccharides in neurodegenerative disease: role of NOX2. Oxidative medicine and cellular longevity. 2020;2020(1):8630275.
• 45. Romero JR, Beiser A, Himali JJ, Shoamanesh A, DeCarli C, Seshadri S. Cerebral microbleeds and risk of incident dementia: the Framingham Heart Study. Neurobiology of aging. 2017;54:94-9.
• 46. Eggermont LH, Aly MF, Vuijk PJ, de Boer K, Kamp O, van Rossum AC, et al. Cardiac function and cognition in older community‐dwelling cardiac patients. Psychogeriatrics. 2017;17(6):356-63.
• 47. Fomin, V., et al., Cognitive impairment in predialysis stages of chronic kidney disease. Zhurnal nevrologii i psikhiatrii imeni SS Korsakova, 2015. 115(12): p. 25-30.