March is National Kidney Month which spotlights the need for comprehensive treatment for those with chronic kidney disease (CKD). Kidney disease is a life-changing diagnosis. Chronic kidney disease involves a gradual loss of kidney function that can culminate in the need for dialysis or a kidney transplant. It is a life-threatening condition that carries a wide array of physiological challenges. 

In addition, kidney disease can impact mental health. Chronic kidney disease patients are more likely to experience depression, anxiety, and other mental health issues. These mental health issues can be related to the stress and concern that result from the diagnosis. Other aspects of mental health may be a side effect of kidney disease itself. 

Explore the connection and steps healthcare providers can take to address this issue. 

Mental Health and Chronic Kidney Disease

According to the Journal of Personalized Medicine, as many as 50 percent of patients who undergo dialysis report symptoms of depression and anxiety. Feelings of fear and sadness are common among patients with a chronic or terminal illness. The nature of the diagnosis, the emotional burden of undergoing treatment, worries about cost, and fears about long-term well-being can all have a direct, stress-related impact on mental health. 

Some researchers have hypothesized that kidney disease can have adverse effects on brain function, causing or exacerbating mental illness. Researchers have examined the possibility that creatinine levels may be responsible for some degree of mental health symptoms. Kidney failure reduces the body’s ability to eliminate creatinine, and excessive amounts of the protein may have negative effects on mental health. 

Other factors related to kidney disease may have effects on a person’s emotional state as well. Kidney disease can impair vascular function and increase inflammation, as well as cause chemical imbalances as waste is imperfectly removed from the body. This may result in changes to neurological function or even damage to the brain or central nervous system. Research is ongoing to explore this possibility and gain a fuller understanding of the issue. 

Managing Mental Illness in Patients With Chronic Kidney Disease

Regardless of the cause of their mental health conditions, the fact remains that many patients with chronic kidney disease experience significant feelings of depression and anxiety. Healthcare providers must be cognizant of the need for emotional support in addition to care for the physiological health of kidney disease patients.  

Providers should be attuned to the signs of depression and anxiety and be prepared to address them with patients and their loved ones. In some cases, it will be appropriate to refer patients to mental health specialists who can directly address their needs. Some patients will benefit from support groups for people with kidney disease, particularly if groups have experienced facilitators who can also provide emotional support. 

Certain lifestyle interventions may have beneficial effects on mood as well. Exercise, proper sleep, and a supportive network of friends, family, and caregivers can reduce the emotional burden on some individuals. 

Medication to manage symptoms of anxiety or depression may be appropriate if not contraindicated by overall health or the need for medications that are incompatible with anti-anxiety or anti-depressant medications. 

Treating CKD means treating the whole person, not simply managing the effects of the disease. Addressing the mental health issues that come with a diagnosis of chronic kidney disease can help patients feel better throughout treatment. 

Taking a comprehensive approach to treating kidney disease is vital to patient care. Explore our many related courses and join the MDBriefCase community to stay current on guidelines.