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How kidney disease takes its toll on mental health

Patients with end-stage kidney disease do not just have to deal with constant physical pressures – it can also have a significant impact on their emotional well-being

Kidney disease affects around 3 million people in the UK. With 70,000 people who are at end stage kidney failure relying on dialysis or a transplant to stay alive, the vast majority of kidney patients are managed in a primary care setting. Around 1 million people are undiagnosed and their kidney disease is often only picked up during a routine medical check or when undergoing investigations for another condition. Many people with kidney disease will also suffer from other long-term conditions such as diabetes, heart disease or frailty.

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Patients with end-stage kidney disease do not just have to deal with constant physical pressures – it can also have a significant impact on their emotional well-being. The majority will require hospital haemodialysis three times a week and this can have an impact on their ability to work or take care of family.

Their lifestyle is curbed due to dietary constraints and they experience difficulty in travelling outside their area even for a short break. Although the gift of a transplant is welcomed, it is not a cure and brings with it its own concerns. Many recipients live with the guilt that someone has died to provide them with the gift of life and the pandemic has brought home to them the dangers of being immunosuppressed – many still continue to live a life of isolation and feel forgotten as restrictions are lifted.

I was a renal nurse for 20 years and witnessed the effects of this disease on my patients and their families. Due to the long-term nature of this disease and treatment there is often a close bond between the renal team and our patients, but on a busy unit it is often difficult to provide that emotional support. I am also one of five generations of my family to suffer from kidney disease, so I have seen first-hand the emotional effects this disease has, not just on the patient but also on their family, carers and wider support network.

Early diagnosis of kidney disease can lead to better long-term outcomes and community practitioners are ideally placed to pick up on any signs and symptoms of this. These might include tiredness, fluid retention, nausea and anorexia or sleep disturbances, and particular attention should be paid to any patients with diabetes or hypertension. We would also ask for your support when caring for anyone with a diagnosis of kidney disease and in helping them to access any support available locally if this is available.

A recent survey carried out by the charity Kidney Research UK found that 67% of kidney patients had experienced symptoms of depression and a quarter had considered self-harm or suicide. However, 68% had not been offered any mental health support. As part of our World Kidney Day campaign on March 10 we are asking that all patients be given access to a qualified renal counsellor and we are calling upon the wider nursing community to join us.

Angela Watt, RN, patient trustee at Kidney Research UK