{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T08:47:49Z","timestamp":1782204469285,"version":"3.54.5"},"reference-count":39,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Psychological resilience is central to emotional adaptation in patients undergoing maintenance hemodialysis (HD). Although psychosocial determinants have been widely studied, the role of routinely monitored biochemical markers remains insufficiently defined. Materials and Methods: This study examined the associations between selected metabolic\u2013inflammatory biomarkers and psychological resilience in adults receiving maintenance HD and explored potential gender-related differences. Resilience was assessed using the Resilience Scale\u201314 (RS-14). \u03b22-microglobulin, serum albumin, calcium, and 25-hydroxyvitamin D were analyzed as continuous predictors. Multiple linear regression models with heteroscedasticity-consistent robust standard errors (HC3) were adjusted for age, HD vintage, diabetes, and cardiovascular disease. Two interaction terms (Gender \u00d7 \u03b22-microglobulin and Gender \u00d7 albumin) were specified a priori. Model stability was evaluated using nonparametric bootstrap resampling (5000 iterations) and penalized regression with cross-validation. Results: In bivariate analyses, higher \u03b22-microglobulin levels were associated with lower resilience (\u03c1 = \u22120.24; p = 0.041), whereas serum albumin showed a positive but non-significant association (p = 0.14). These relationships did not remain statistically significant in fully adjusted models (\u03b22-microglobulin: p = 0.107). No Gender \u00d7 Biomarker interaction reached statistical significance (p = 0.162). Stratified analyses showed consistent directional patterns across gender groups. Conclusions: Metabolic\u2013inflammatory biomarkers, particularly \u03b22-microglobulin and serum albumin, may be associated with psychological resilience in HD. However, gender-specific effects were not supported in adjusted analyses. These findings require validation in larger, longitudinal, multicenter studies.<\/jats:p>","DOI":"10.3390\/medicina62061207","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T06:13:37Z","timestamp":1782195217000},"page":"1207","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Biological and Metabolic Correlates of Psychological Resilience in Maintenance Hemodialysis: An Exploratory Gender-Based Study"],"prefix":"10.3390","volume":"62","author":[{"given":"Gloria Mar\u00eda","family":"Zaragoza Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Department of Nephrology, Central Defense Hospital G\u00f3mez Ulla, 28047 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0633-6325","authenticated-orcid":false,"given":"Avinash","family":"Chandu Nanwani","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital General de Fuerteventura, 35600 Fuerteventura, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3005-7039","authenticated-orcid":false,"given":"Elena","family":"Jim\u00e9nez Mayor","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Santa B\u00e1rbara, 42003 Soria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9873-3043","authenticated-orcid":false,"given":"Celia","family":"Rodr\u00edguez Tudero","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario de Salamanca, 37007 Salamanca, Spain"},{"name":"Surgery Department, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3690-6598","authenticated-orcid":false,"given":"Esperanza","family":"Moral Berrio","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital General Universitario de Ciudad Real, 13005 Ciudad Real, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alonso","family":"Gonz\u00e1lez de Gregorio","sequence":"additional","affiliation":[{"name":"Psychology Area, True Horizon Consulting, 08034 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9104-488X","authenticated-orcid":false,"given":"Marco","family":"Vaca Gallardo","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Gregorio Mara\u00f1on, 28007 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrique Antonio","family":"Florit","sequence":"additional","affiliation":[{"name":"Clinic Institute of Nephrology and Urology, Hospital Clinic, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9346-2279","authenticated-orcid":false,"given":"Jos\u00e9 C.","family":"De La Flor","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Central Defense Hospital G\u00f3mez Ulla, 28047 Madrid, Spain"},{"name":"Department of Medicine and Medical Specialties, Faculty of Medicine, Alcala University, 28805 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1814-5254","authenticated-orcid":false,"given":"Rafael","family":"Fern\u00e1ndez Castillo","sequence":"additional","affiliation":[{"name":"Biosanitary Research Institute of Granada (ibs.GRANADA), 18010 Granada, Spain"},{"name":"Nursing Department, University of Granada, 18012 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ba\u015fkaya, E., and F\u0131r\u0131nc\u0131k, S. 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