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Psychiatric disorders among patients undergoing hemodialysis therapy
Isao Fukunishi1, Tateki Kitaoka, Tetsuo Shirai
1Tokyo Institute of Psychiatry, Tokyo Metropolitan Organization for Medical Research, Japan. fukunisi@prit.go.jp
Insights
End-stage renal failure patients on hemodialysis have high rates of psychiatric disorders, particularly dementia and major depression. Aged patients on long-term hemodialysis show a significantly higher incidence of multi-infarct dementia.
Area of Science:
- Nephrology
- Psychiatry
- Geriatrics
Background:
- End-stage renal failure (ESRD) patients undergoing hemodialysis (HD) face significant health challenges.
- Psychiatric comorbidities are common but require further investigation in this population.
Purpose of the Study:
- To determine the incidence rates of psychiatric disorders in ESRD patients on HD.
- To identify specific psychiatric conditions prevalent in this cohort, especially in aged individuals.
Main Methods:
- A 4-year long-term follow-up study was conducted.
- Incidence rates of psychiatric disorders were systematically recorded.
- Data stratified by age groups (aged vs. non-aged) and specific diagnoses were analyzed.
Main Results:
- The overall one-year incidence of psychiatric disorders was 10.6% (13.7% in aged, 7.1% in non-aged).
- Dementia incidence in aged HD patients was 4.2% (Alzheimer's disease 0.5%, multi-infarct dementia 3.7%).
- Multi-infarct dementia incidence in aged HD patients was 7.4 times higher than in the general elderly population, linked to arteriosclerosis.
Conclusions:
- Dementia, delirium, and major depression are frequent psychiatric disorders in HD patients.
- Aged HD patients, particularly those with long-term therapy, exhibit a high risk for multi-infarct dementia.
- Proactive psychiatric management is crucial for ESRD patients, especially for aged individuals with multi-infarct dementia.
Abstract:
We examined the incidence rates of psychiatric disorders in end-stage renal failure patients on hemodialysis (HD) based on 4-year long-term follow-up. Among various psychiatric disorders, the frequency of three psychiatric disorders, dementia, delirium, and major depression, was relatively high. One-year incidence rate of whole psychiatric disorders was 10.6% (7.1% in non-aged and 13.7% in aged). One-year incidence rate of dementia in aged patients was 4.2% (dementia of the Alzheimer's disease, 0.5%; multi-infarct dementia, 3.7%). One-year incidence rate of multi-infarct dementia in aged HD patients was 7.4 times as large as that in the elderly general populations, suggesting that aged HD patients tend to exhibit multi-infarct dementia. The high incidence rate may be closely related to advanced arteriosclerosis and other medical conditions. Psychiatric management is required for ESRD patients with three major psychiatric disorders, dementia, delirium, and major depression, in particular for aged patients with multi-infarct dementia who has received long-term HD therapy.