Fibromyalgia syndrome in chronic hemodialysis patients is associated with depression, hypoalbuminemia and inflammation

Year 2019, Volume: 5 Issue: 5, 729 - 733, 04.09.2019

Bahar Gürlek Demirci , Emre Tutal , Mehtap Erkmen Elçin Erdoğan Siren Sezer

https://doi.org/10.18621/eurj.423605

Cited By: 1

Abstract

Objectives: Fibromyalgia syndrome (FMS) is an
entity that presents with wide-spread chronic pain in musculoskeletal system, disturbed sleep, reduced mental functioning and depressed mood. We aimed to
determine the incidence of FMS in our hemodialysis patients and to evaluate the
association between FMS, depression and inflammation in patients ongoing
hemodialysis.

Methods: Among 169 patients, 140
patients were enrolled into our study. Twenty-nine
patients were excluded according to exclusion criteria. Demographic characteristics including age, sex, body mass index,
duration of dialysis, the etiology of end stage renal disease, the dialysis
adequacy (Kt/V) were also recorded. All patients were evaluated through 2010
ACR preliminary diagnostic criteria including widespread pain index (WPI)
and total symptom severity. All subjects completed Beck
depression inventory (BDI) to determine psychological status.

Results: Among 140 hemodialysis
patients, 76 (54.2%) patients presented chronic widespread pain and 20 patients
(14.2%) met the 2010 ACR criteria for FMS. Patients were divided
into FMS (n = 20; 14.2%) and non-FMS (n = 120; 85.8%) groups. FMS group had
significantly higher serum C-reactive protein levels and lower serum albumin
levels when compared to non-FMS group. BDI (31.4 ± 1.4 vs 14.8 ± 0.6, p < 0.005), WPI (11.2 ± 0.7 vs 2.8±
0.2, p = 0.002) and symptom severity (7.3 ± 0.3 vs 3.7 ± 0.1,
p < 0.005) scores were
significantly higher in FMS group.

Conclusions: The FMS itself and the
related symptoms were correlated with depression in maintenance hemodialysis
patients. Besides, inflammation and perhaps malnutrition-inflammation sydrome
may trigger FMS in this population.

 

Keywords

Fibromyalgia, hemodialysis, depression

References

• [1] Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 1990;33:160-72.
• [2] Bernardy K, Klose P, Welsch P, Häuser W. Efficacy, acceptability and safety of internet-delivered psychological therapies for fibromyalgia syndrome - A systematic review and meta-analysis of randomized controlled trials. Eur J Pain 2018 Jul 8. doi: 10.1002/ejp.1284.
• [3] Biewer W, Conrad I, Häuser W. [Fibromyalgia]. Schmerz 2004;18:118-24. [Article in German]
• [4] Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford) 2003;42:263-7.
• [5] Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010;62:600-10.
• [6] Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995;38:19-28.
• [7] Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken) 2011;63 Suppl 11:S467-72.
• [8] Chakrabarty S, Zoorob R. Fibromyalgia. Am Fam Physician 2007;76:247-54.
• [9] Wernze H, Herdegen T. Long-term efficacy of spironolactone on pain, mood, and quality of life in women with fibromyalgia: An observational case series. Scand J Pain 2017;5:63-71.
• [10] Yuceturk TE, Yucel AE, Yuceturk H, Kart-Koseoglu H, Unuvar R, Ozdemir FN, et al. Fibromyalgia: its prevalence in haemodialysis patients and its relationships with clinical and laboratory parameters. Nephrol Dial Transplant 2005;20:2485-8.
• [11] Omoigui S. The biochemical origin of pain: the origin of all pain is inflammation and the inflammatory response. Part 2 of 3 - inflammatory profile of pain syndromes. Med Hypotheses 2007;1169-78.
• [12] Wolfe F . Fibromyalgia: the clinical syndrome. Rheum Dis Clin North Am 1989;15:1-18.
• [13] Roizenblatt M, Rosa Neto NS, Tufik S, Roizenblatt S. Pain-related diseases and sleep disorders. Braz J Med Biol Res 2012;45:792-8.
• [14] Homann D, Stefanello JM, Góes SM, Breda CA, Paiva Edos S, Leite N. Stress perception and depressive symptoms: functionality and impact on the quality of life of women with fibromyalgia. Rev Bras Reumatol 2012;52:319-30. [Article in English, Portuguese]
• [15] Cavalcante AB, Sauer JF, Chalot SD, Assumpção A, Lage LV, Matsutani LA, et al. [The prevalence of fibromyalgia: a literature review]. Rev Bras Reumatol 2006;46:40-8. [Article in Portuguese]