Psychological effects of chronic haemodialysis

Ninety-four patients, partly on chronic haemodialysis, partly after successful kidney transplantation, were studied. Progress of perceptual performance was followed up by measurements of the reaction time. It is pointed out that accumulation of uraemic toxins causes permanent damage to the central nervous system. The psychological tests revealed behavioural and personality deviations typical of other chronic diseases, the main features being growing anxiety, neuroticitation, sense of inferiority, egocentric attitude, primitive defense reactions, social introversion, distorted image of the ego, etc. Dependence of the patients on the medical or nursing staff and on the dialysing system also favour these symptoms. The uncertain outcome of the illness and the "over-protective" attitude of the close or the more distant milieu also add to the sense of insecurity and uselessness. The need for individual and group psychotherapy is emphasized.