Psychiatric disorders among patients undergoing hemodialysis therapy

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Isao Fukunishi1, Tateki Kitaoka, Tetsuo Shirai

  • 1Tokyo Institute of Psychiatry, Tokyo Metropolitan Organization for Medical Research, Japan. fukunisi@prit.go.jp

Nephron
|June 8, 2002
PubMed

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.

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