International Journal of Nephrology 5 Table 5: Modiﬁed Scale of Birleson and frequency of symptoms of the 67 patients; it is presented as an original sample, and it has been literally translated in order to have a better understanding of depressive symptomatology. Always have a score of 2, sometimes of 1, and never of 0. Questions Equivalent in English (1) Las cosas me gustan, me interesan I like and am still interested in the same como antes things as before (2) Duermo muy bien I sleep well (3) Me dan ganas de llorar I feel like crying (4) Para adolescentes: me gustan salir For adolescents: I like going out with my com amigos. Para nin˜os: me gusta salir a friends. For children: I like going out to jugar play (5) Me gustaria escapar, salir corriendo I would like to run away (6) Me duele la barriga, cabeza y otros My stomach and my head hurt, as well as s´ıtios de mi cuerpo other parts of my body (7) Tengo ganas para hacer las cosas I have a desire to do things (8) Disfruto de la comida I enjoy eating food (9) Puedo defenderme por mi mismo I am able to defend myself (10) Pienso que no vale la pena vivir I feel that life is not worth living (11) Soy bueno para las cosas que hago I am good at the things I do (12) Me molesto y me irrito por cualquier I feel bothered and irritated with cosa everything (h1a3c)iaDainsftreusto lo que hago tanto como lo I still enjoy doing things as I did before (14) Me he vuelto olvidadizo y distra´ıdo I have become forgetful and listless (15) Tengo suen˜os horribles I have nightmares I think that it does not matter what I do; I (16) Pienso que haga lo que haga no will never be able to accomplish the lograre conseguir lo que deseo o que las things I want to accomplish; things are cosas no van a cambiar never going to change (17) Me siento muy solo I feel very lonely (18) Puedo alegrarme facilmente I become happy easily (19) Me siento tan triste que me cuesta I feel so sad that I can hardly stand it trabajo soportarlo (20) Me siento muy aburrido I feel very bored (21) Pienso muy serio en la muerte o en I seriously think about death and killing matarme myself Total Always % Sometimes Never 34.32 (n = 23) 59.70 (n = 40) 5.97 (n = 4) 64.18 (n = 43) 11.94 (n = 8) 31.34 (n = 21) 55.22 (n = 37) 4.47 (n = 3) 32.83 (n = 22) 38.80 (n = 26) 35.82 (n = 24) 25.37 (n = 17) 10.45 (n = 7) 5.97 (n = 4) 37.32 (n = 25) 55.22 (n = 37) 43.28 (n = 29) 16.42 (n = 11) 47.76 (n = 32) 29.85 (n = 20) 59.70 (n = 40) 41.79 (n = 28) 52.23 (n = 35) 50.74 (n = 34) 38.80 (n = 26) 38.80 (n = 26) 28.35 (n = 19) 41.79 (n = 28) 11.94 (n = 8) 5.97 (n = 4) 17.91 (n = 12) 55.22 (n = 37) 10.44 (n = 7) 23.88 (n = 16) 55.23 (n = 37) 20.89 (n = 14) 43.29 (n = 29) 47.76 (n = 32) 8.95 (n = 6) 7.46 (n = 5) 4.47 (n = 3) 55.22 (n = 37) 35.82 (n = 24) 37.32 (n = 25) 59.70 (n = 40) 31.34 (n = 21) 31.34 (n = 21) 37.32 (n = 25) 11.94 (n = 8) 41.79 (n = 28) 37.31 (n = 25) 50.74 (n = 34) 50.74 (n = 34) 7.46 (n = 5) 20.91 (n = 14) 28.35 (n = 19) 50.74 (n = 34) 16.42 (n = 11) 58.21 (n = 39) 25.37 (n = 17) 8.95 (n = 6) 19.41 (n = 13) 71.64 (n = 48) adolescents with terminal chronic renal insuﬃciency and 22 predialysis children and adolescents with chronic rena in- suﬃciency, compared to healthy children) and that these in- crease in those whose renal disease is more severe [14]. Children with terminal chronic renal insuﬃciency have growth retardation and develop secondary sexual character- istics, bone deformities, multiple scars, and so forth. As a consequence of bone dystrophy, uremia, and the treatment, the children look and feel diﬀerent from other children, thus increasing the risk of psychiatric problems such as depression [15]. Before puberty, depression is more frequent in males, while in the postpuberty period it predominates in females. This is consistent with our results, where all of the children with high occurrence of depressive symptomatology were female and their average age was 14.76 ± 2.71. This diﬀers from other studies that did not ﬁnd any relationship with gender [4, 10]. Peritoneal dialysis patients without depressive symp- tomatology had a better Kt/V value than patients with de- pressive symptomatology, which was signiﬁcant (P = 0.01). We could infer that depression as comorbidity is a negative clinical factor. Another study did not show any relationship with Kt/V [16]. There is evidence that suboptimal dial- ysis increases mortality in patients undergoing peritoneal dialysis and hemodialysis with cardiac, cerebral, and other comorbidities. A Kt/V that diminishes by 0.1 weekly is associated with a 5% increase in relative death risk [8, 17],