Evaluation of anxiety, depression and urinary protein excretion among the family caregivers of advanced cancer patients

Caregiving to a family member with advanced cancer can be stressful. Stress leads to psychological changes, oxidative stress and increased glomerular permeability to proteins. To find out their association with stress, we assessed anxiety and depression by the hospital anxiety and depression scale (HADS), urinary malondialdehyde:creatinine ratio (UMDA:Cr), urinary protein:creatinine ratio (UP:Cr) and SDS-polyacrylamide gel electrophoresis (SDS-PAGE) profile of urinary proteins in 31 family caregivers of advanced cancer patients and 31 matched controls. HADS, UMDA:Cr and UP:Cr were significantly higher in the caregivers as compared to the controls. These parameters were significantly correlated. Besides an increase in albumin excretion, a few higher and lower molecular weight proteins were detected in the urine of caregivers. These results indicate that the family caregivers of advanced cancer patients undergo anxiety and depression associated with stress leading to increased oxidative stress and glomerular permeability to proteins. These changes might have health implications, warranting appropriate stress management counseling for them.