Renal Diseases

Supervised by: Presented by:

Dr. Deepak Salvi Siddhi Jain
AIBAS
 Why study this topic???
Psychosocial issues are an understudied yet
important concern in the overall health of
hemodialysis (HD) patients.

Stress is a concomitant of chronic illness and

its treatment, and may have meaningful
influences on psychological and medical
outcomes.
Common Psychological Problems
• Depression and other affective disorders
• Suicide
• Anxiety
• Substance Use
• Cognitive disorders (Mild cognitive dysfunction,
delirium)
• Restless leg syndrome
• Sleep disorders
• Vascular and Alzheimer’s Dementia
• Sexual dysfunction
 In a review of hospitalization data from US Medicare ESRD (End
Stage Renal Disease) patients who were treated with dialysis in 1993,
the most common psychiatric disorders in the population were

• depression and affective disorders (26%),

• organic brain syndromes and dementia (26%),
• schizophrenia and other psychoses (22%), and
• drug and alcohol abuse (15%).
In Brooklyn data, urban HD (hemodialysis) patients had
an active

• substance abuse diagnosis 19%

• 10% had a diagnosis of psychosis.

In an in-depth analysis of alcohol use in 163 urban

HD patients, 27.6% were found to have troublesome
use of alcohol.
 Management
• Psychoeducation, counselling, psychotherapy
• Involving families, caregivers
• Group therapies, Cognitive Behavior Therapy,
Interpersonal Psychotherapy,
• Stress management, Social Skills Training
• Marital counselling
• Patient self-help
• Stress management, burnout of caregivers
• Diet management
 Encouragement
The role of the health care professional is to
encourage and, where possible,
• to enable patients to accept responsibility for their
health and well-being and
• to fulfill their obligations within the family and
society
• providing knowledge and clarifying misconceptions,
• encourage patients to accept the personal limitations
consequent to the illness and its treatment
• encourage to perform self-care
 Support to Family
Family members play an important role in the wellbeing of the
patient.
They should not be neglected in the process of patient care.
A change in the pattern of family life (integrating the lives of
family members more flexibly with the patient’s life) may be
necessary to meet the patient’s needs.
The patient and the family should be encouraged to share their
feelings in a trusting relationship and to make flexible
adjustments to cope with the course of the patient’s illness.

Sadness and guilt in partners and family members is common.