Depression Treatment For Kidney Disease Patients

Depression is profoundly common and is related with low quality of life and expanded mortality among grown-ups with Chronic kidney disease (CKD), incorporating those with end-stage renal sickness (ESRD).

Depression can be hard to distinguish in individuals living with kidney disease in light of the fact that a significant number of the key side effects, like sleep deprivation, deficiency of weight or craving and low energy, can likewise be credited to kidney disease itself.

In spite of this, nonetheless, individuals with kidney disease and kidney failure face higher paces of depression collectively. unlike kidney disease, the rate of depression across orientation and racial lines among individuals living with kidney disease is genuinely equivalent, meaning it can influence anybody. Depression can prompt less fortunate wellbeing results, expanded hospitalizations, lower personal satisfaction and that's only the tip of the iceberg.

There has been cases where people get mis-diagnosed with depression because of the similarities shown in depression and kidney disease symptoms. If you want to know what are the signs of kidney disease, then read our article; Signs of kidney disease, expanding further on the signs that may indicate kidney disease and how to test kidney function.

What are the signs of depression in kidney disease patients?

• Physical pain on your back, from neck to your lower body
• Sensations of frailty over the sickness
• Anxiety that their life is in the hands of those who care for them and their disease
• Feeling that you've become a burden to people around you who are helping you
• Feelings of hopelessness as there is ultimately no cure for kidney disease 
• Isolation (withdrawal from family, friends, and social gatherings)
• Poorer compliance with medical follow-up and dialysis
• Decreased self-care

The great news is that depression is very much treatable with or without medication

What is used to treat depression in Kidney disease patients?

According to our very trusted source NIH,  In an analysis, adults with CKD stage 3 to 4 and elevated depressive symptoms who were enrolled in the CRIC and HCRIC studies, only 31% reported receipt of antidepressant medication. In another study of 928 adults with ESRD on long-term hemodialysis and physician-diagnosed depression, only 34.9% were receiving antidepressant medication.

The analysis showed that antidepressants are working, But we need to keep in mind that not all antidepressants are recommended to kidney disease patients, Which ones are recommended and safe for CKD patients?

Antidepressant medication for CKD 

Selective serotonin reuptake inhibitor  (SSRI)	Adjustment.	Dosage.
Sertraline	50–200 mg/d	__
Citalopram	10–40 mg/d	__
Fluoxetine	20–60 mg/d	__
Escitalopram	10–20 mg/d

Tricyclics (TCA).	Adjustment.	Dosage.
Imipramine	100–300 mg/day	__
Nortriptyline	75–150 mg/d.	__
Desipramine	100–300 mg/d	__

Psychotherapy

All forms of psychotherapy include support from a professional who is focused on helping you to make positive changes. There are many specific types of psychotherapy that are used to treat depression. In this case Cognitive-Behavioral Therapy (CBT) is used treat dysfunctional cognitions, negative emotions, and maladaptive behaviors that are present in Kidney disease patients with depression.

Do you want to learn more about kidney disease? Read Kidney disease flu tips and ways to keep your kidneys healthy  

How Depressive symptoms lead to rapid kidney function decline

Depression is a common disorder in middle-aged and older individuals, and it can contribute to a wide range of mental and physical health issues. Previous study has discovered a relationship between depressed symptoms and fast renal function decrease in chronic kidney disease patients (CKD).

Kidney doctors have long recognized that people with CKD frequently suffer from depression.

Research Clinical Trials:

Dr. Qin and the research's co-authors examined data from persons who took part in the China Health and Retirement Longitudinal Study (CHARLS), a national study of China's middle-aged and older population.

The researchers took comprehensive measures from 4,763 people aged 45 and up with healthy kidneys. The average age was 59, and males made up 45% of the study population.

The researchers examined data from 2011, 2013, and 2015, as well as doing one-on-one interviews and follow-ups.

Doctors took physical measures and drew blood samples every two follow-up cycles throughout each 2-year check-up.

The estimated glomerular filtration rate was used by the researchers to assess renal function (eGFR). They used a 10-item Center for Epidemiologic Studies Depression (CES-D) scale to measure depressed symptoms.

The Study's Results and follow ups:

During a four-year average follow-up, 260 patients, or 6%, showed accelerated renal impairment.

After controlling for demographic, psychological, and clinical characteristics, the researchers discovered in the general population a "significant positive correlation between baseline depressed symptoms and fast deterioration in kidney function."

They discovered that people with strong depressive symptoms" had a 39% higher chance of "rapid deterioration in kidney function.

Effects of depressive symptoms on the body

The current study did not completely explore the precise processes underlying how depressed symptoms may elevate a person's risk of a quick deterioration in kidney function. However, a number of alternative processes were put up as the cause of this phenomena.

Numerous prior studies have shown that people with severe depressive symptoms frequently have higher levels of inflammatory cytokines in their blood, such as interleukin-6 (IL-6) and tumor necrosis factor (TNF-). Together, an increase in these inflammatory markers in the blood can cause kidney fibrosis and endothelial dysfunction, both of which are linked to a rapid decline in kidney function.

Depressed symptoms may lessen the immune system's susceptibility to glucocorticoid hormones. An autonomic imbalance results as a result, which can stimulate the hypothalamic-pituitary-adrenal axis and, as a result, decrease the immune system's ability to operate.

Potential triggers of rapid kidney decline

People with CKD are more likely to suffer from depression, a common mental health issue. It could trigger a number of "potential processes" that might hasten the decline in kidney function.

Health behaviors

Additionally, according to the study's authors, kidney function may be harmed by health-related practices including inadequate diet, a decline in social engagement, physical inactivity, and a refusal to seek medical attention.

Inflammation

A study published in World Psychiatry claims that 25–50% of persons with depression experience elevated inflammation, the first potential reason.

The authors of the current study claim that prior studies have revealed greater amounts of circulating inflammatory proteins known as cytokines in persons with serious depression. These cytokines may cause autoimmune reactions that result in the layer of cells that lines blood arteries, the endothelium, becoming dysfunctional. Additionally, it could cause renal fibrosis, which results in kidney disease.

Education level

The researchers discovered that participants who continuously had the greatest levels of depression symptoms had limited access to educational opportunities and, as a result, may be less emotionally resilient or knowledgeable of how to take care of oneself.

Conclusions

The results of the present investigation supported the hypothesis that high levels of depression symptoms are associated with a more rapid deterioration in kidney function in healthy persons.

The information presented here supports the use of effective psychosocial interventions and screening for depressed symptoms in the clinical context, even if further research is necessary to completely understand the development of kidney disease in healthy people with depression symptoms. Certain initiatives will probably prevent the onset of chronic renal disease in these patient populations that are at risk.