Psychiatric issues in renal dialysis and transplantation

Hemodialysis and kidney transplantation are often accompanied by psychological problems that can affect the medical course of the illness. The most frequent problems include depression, noncompliance with diet and medication, and sexual dysfunction. Approximately one-fourth of dialysis patients are depressed at any one time, and 2.7 percent of transplant patients experience affective psychosis. In addition, about 1 percent of the dialysis patients will commit suicide. Following transplantation body image problems may occur, primarily arising from the introjection of the new organ and from the disfiguring side effects of steroid medication. The author summarizes the pertinent psychiatric literature and treatment modalities available.