Association between B-cell activating factor and future depressive symptoms in hemodialysis patients

B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) are cytokines that play critical roles in the maturation, homeostasis, and differentiation of B-cells. Both cytokines have also been associated with mental disorders. The link between inflammation and depression is well-established. Patients undergoing hemodialysis who also experience depressive symptoms exhibit a state of immune dysfunction. We hypothesized that BAFF and APRIL levels would influence future depressive symptoms in hemodialysis patients.

We enrolled 72 hemodialysis patients without baseline depressive symptoms. Depressive symptoms were assessed annually for 2 years using the Beck Depression Inventory-II. The participants were measured for plasma BAFF, APRIL, and tumor necrosis factor-a levels. To evaluate the impact of these levels on the development of depressive symptoms, we performed Cox regression and Kaplan-Meier analysis.

Depressive symptoms were observed in 31 (43.1%) patients. In both univariate and multivariate Cox regression analyses, a 1 SD increase in BAFF was significantly associated with an increased risk of future depressive symptoms, with hazard ratios of 1.44 (95%CI 1.03-2.00) and 1.70 (95%CI 1.04-2.78), respectively. Higher BAFF groups had a significantly greater incidence of depressive symptoms over 2 years (p = 0.048).

Elevated plasma BAFF levels were significantly associated with the development of depressive symptoms in hemodialysis patients.