Renal diseases and psychiatry
The kidney is one of the most important organs of the body. It plays an important role in the water and electrolyte balance and the elimination of toxic substances. Various infections, auto-immune diseases, toxic substances, drugs etc. can interfere with the kidney fulfilling its above mentioned functions and can result in a renal diseases. Glomerulonephritis, pyelonephritis etc. are some of the many possible renal diseases.
Sometimes progression can be insidious, other times sudden. One of the primary symptoms is hypertension. Another one is hyperglycaemia. It can occur in people of any age.
If we look at psychiatric reasons for the disease, nephritis due to illegal substance abuse, or due to the toxic effects of psychotrophic drugs etc. can be regarded as forming a connection to psychiatry.
It is a really widespread problem. In the USA approximately 100,000 people suffer from the disease every year. The cost involved is around 12 billion USD.
The primary effects on the patient are, that chronic kidney disease will make them dependent on dialysis and that it involves various complications.
The medical discipline that deals with kidney diseases is called nephrology.
Two primary characteristics of renal patients is denial and fear of death, the most important one being denial. For this reason they tend to be unwilling to go along with medical care. Another group of patients wish to die and therefore consciously avoid treatment.
Depression is one of the main symptoms of kidney disease. The patient may feel inadequate and hopeless.
The use of psychotrophic drugs and psychotherapy is sufficiently effective in overcoming these symptoms. Group therapy in particular is seen to be very effective.
The approach of the family should be a supportive one.
In patients on dialysis, functionality is greatly affected. It is important that this is taken into careful consideration when dealing with kidney patients, and that the expectations and targets are not set too high.
The moment when a picture of renal failure appears, transplant is indicated. Patients prefer this to dialysis as it offers a better quality of life. The fact that the illness prevents the patient from fully understanding the side effects and risks of a transplant, is one of the factors that makes transplant a difficult choice from an ethical point of view.