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

Abstract

Objectives: Fibromyalgia syndrome (FMS) is an entity that presents with wide-spread chronic pain inmusculoskeletal system, disturbed sleep, reduced mental functioning and depressed mood. We aimed todetermine 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 excludedaccording to exclusion criteria. Demographic characteristics including age, sex, body mass index, duration ofdialysis, the etiology of end stage renal disease, the dialysis adequacy (Kt/V) were also recorded. All patientswere evaluated through 2010 ACR preliminary diagnostic criteria including widespread pain index (WPI) andtotal symptom severity. All subjects completed Beck depression inventory (BDI) to determine psychologicalstatus.Results: Among 140 hemodialysis patients, 76 (54.2%) patients presented chronic widespread pain and 20patients (14.2%) met the 2010 ACR criteria for FMS. Patients were divided into FMS (n = 20; 14.2%) andnon-FMS (n = 120; 85.8%) groups. FMS group had significantly higher serum C-reactive protein levels andlower 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 weresignificantly higher in FMS group.Conclusions: The FMS itself and the related symptoms were correlated with depression in maintenancehemodialysis patients. Besides, inflammation and perhaps malnutrition-inflammation sydrome may triggerFMS in this population.