SP704
THE EFFECT OF MIRTAZAPINE IN DIALYSIS PATIENT WITH APPETITE LOSS Free

Introduction and Aims: Depression is the most common psychological complication which occurs in Hemodialysis patients. More importantly, depression contributes significantly to increased risks of mortality and hospitalization in hemodialysis patients. In patients undergoing chronic hemodialysis therapy, depression is related closely to nutritional status and is considered to be an independent risk factor for malnutrition. It could also be associated with poor oral intake and activation of proinflammatory cytokines that could further increase mortality. However, Treatment for anorexia has not been well established. Mirtazapine has an excellent appetite improvement effect among therapeutic agents of depression, thus we examined the effect of Mirtazapine on improving nutrition and appetite in dialysis patients with depression and appetite loss.

Methods: Among 160 patients undergoing maintenance dialysis at Yokohama Minami Clinic, 65 patients with anorexia and a tendency for depression participated in this study. We divided these patients into the Mirtazapine group (n=31) and the non-administrated group (n=34). We gave 15 mg of Mirtazapine a day to the first group (the Mirtazapine group). In (the control group)?. We examined the dry weight, PCR, serum total protein (TP), albumin in both groups for up to six months.

Results: In regards to the dry weight, no change was noted in the control group from 58.07±11.56 kg to 58.15±11.15 kg (P=0.39), but it significantly increased from 51.5±9.8 kg to 52.5±10.1 kg in the Mirtazapine group (P=0.04). As for the PCR, no change was noted in the control group from 0.86±0.11 to 0.83±0.10 (P=0.30), but it significantly increased from 0.80±0.11 to 0.86±0.14 in the Mirtazapine group (P=0.01).The serum TP significantly decreased from 6.53±0.50g/dl to 6.39±0.50g/dl in the control group (P=0.02), but significantly increased from 6.46±0.53g/dl to 6.63±0.48g/dl in the Mirtazapine group (P=0.01). Serum albumin significantly decreased from 3.73±0.24g/dl to3.65±0.22g/dl in the control group (P=0.01), but it significantly increased from 3.48±0.28g/dl to 3.57±0.30g/dl in the Mirtazapine group (P=0.02).The mortality rate of patients on dialysis is greatly improved by increasing protein intake and is well known to be connected to nutrition indexes such as serum albumin level.

Conclusions: In this study, dialysis patients with depression and lack of appetite were given Mirtazapine. As a result, a noticeable improvement in Dry weight, PCR, serum TP, albumin was shown. Future research needs to be done to assess whether treatment of depression by Mirtazapine administration may help to improve the quality of life and survival rate of hemodialysis patients.