[Psychiatric aspects in the starting and ending of chronic dialysis]

Various symptoms are discussed which are of importance in patients undergoing maintenance dialysis for chronic renal failure, such as depression, organic brain syndrome, ambiguity regarding a chronic "incurable" disease, sexual dysfunction and suicidal behaviour. A number of criteria that should be considered at the beginning and termination of regular dialysis treatment are described. Six case reports of selected patients with chronic renal failure and psychiatric problems are discussed. For psychiatric reasons one female patient was not started on maintenance dialysis. One of the patients, a female, did well on maintenance dialysis. One patient died due to medical complications for which treatment was withheld. Two patients decided to quit maintenance dialysis with their doctor's approval. One patient committed suicide unexpectedly.