Association of uremic toxins and systemic inflammation with depression and anxiety among hemodialysis patients in Montenegro.

This study investigated the association between uremic toxins, systemic inflammation, and symptoms of depression and anxiety in 88 hemodialysis patients in Montenegro. Using the Patient Health Questionnaire (PHQ-9) and Beck Anxiety Inventory (BAI), clinically significant depression and anxiety were found in 55.7% and 27.2% of patients, respectively. Logistic regression analyses identified serum urea, beta 2-microglobulin (B2M), and inflammatory markers—including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR)—as significant independent predictors of depressive symptoms, while urea, creatinine, uric acid, B2M, CRP, and NLR were associated with anxiety symptoms. The findings suggest that uremic toxins and systemic inflammation may contribute to the high prevalence of affective disorders in hemodialysis patients, highlighting potential biological pathways relevant for clinical management in end-stage renal disease.