According to the National Institute of Mental Health, one in five adults in the United States lives with a mental illness (1). Patients living with the spectrum of kidney diseases—including nondialysis chronic kidney disease, dialysis-dependent kidney failure, and kidney transplantation—have high rates of mental illnesses and face a complex emotional landscape related both to kidney diseases themselves and their available treatment options. In honor of National Mental Health Awareness Month, this special issue of Kidney News is dedicated to shining a light on some of these important concerns, including clinically diagnosed mental illnesses as well as unique stressors and emotional concerns affecting people living with kidney diseases.
Patients with kidney diseases may experience fear, hopelessness, frustration, depression, anxiety, and guilt related to anticipating kidney failure, living with dialysis dependence, and receipt of a transplanted kidney. These feelings, along with the symptom burden and poor quality of life that frequently affect patients with kidney diseases, may contribute to high rates of depression and anxiety. Although kidney transplantation can greatly improve quality of life for patients with kidney failure, it brings its own stressors and emotions. In addition to these concerns, certain populations of patients affected by kidney diseases—including children, Black and Latinx individuals, and undocumented immigrants—face additional sociocultural concerns related to living with chronic illness, access to care, and organ transplantation. For patients receiving dialysis, social and emotional considerations about stopping dialysis treatments can complicate the experience of end-of-life care.
Understanding, or at least acknowledging, these concerns is crucial to enabling patients to communicate with their care team honestly and openly about their mental health. Fortunately, increased attention to research about mental health among patients with kidney diseases has led to important advancements in treatment options. There is now evidence to support the efficacy of some pharmacologic therapies, such as selective serotonin reuptake inhibitors, and nonpharmacologic therapies, such as cognitive behavioral therapy and physical activity, for the treatment of depressive symptoms among patients with kidney diseases. Professional mental health care, a communicative nephrology care team, and peer-support networks can also all reinforce improved well-being.
The articles in this issue of Kidney News reflect some of the breadth of mental health difficulties that patients with kidney diseases experience and offer strategies to mitigate these concerns. We hope that readers benefit from the perspectives herein and can carry forward a new awareness to the clinic room and the bedside for the benefit of patients who may be struggling with mental health concerns.
Footnotes
Reference
National Institute of Mental Health, National Institutes of Health. Mental illness. Accessed March 20, 2024. https://www.nimh.nih.gov/health/statistics/mental-illness
