Psychological Distress in End-stage Renal Disease Patients: Prevalence and Associated Factors. a Literature Review

Background: Mental disorders such as depression, anxiety, stress, and mental pain are well known to affect adults with end-stage chronic kidney disease and those undergoing dialysis. Patients undergoing dialysis also face several other problems related to their daily lives, changes in their financial and professional duties and many challenges that increase the likelihood of developing mental disorders such as depression and anxiety. Objective: The aim of the present study is to investigate the mental strain in CKD as it is reflected in the studies of modern literature as well as to highlight the factors related to it. Mehods: A review of the recent literature was performed. We employed the framework of Whittemore and Knaff according to which there are five stages for the review: problem identification, Literature Search, Data Evaluation, Data Analysis, and presentation. A systematic search was conducted on the following databases: Medline, Scopus, PsychInfo. We reviewed both qualitative and quantitative studies, peer-reviewed, published in the English language in the years 2015-2020. Results and Discussion: The prevalence of mental stress in ESRD varies widely in different studies, ranging from 10% to 29%. Also, according to studies about 30% of patients with CKD experience mental stress. A number of factors, including female gender, low educational attainment, advanced age, retirement, low financial status, comorbidities, family functioning, general well-being, and exercise were noted to be associated with psychological distress. The prevalence of depression varies, with this variation may be affected by both cultural differences in the individual populations under study and different methodological approaches. Conclusion: The effect of gender on mental health has been much debated in recent years, with most researchers agreeing that women undergoing dialysis experience higher levels of stress than men. Comorbidities have also been significantly associated with the presence of psychiatric symptoms, with those who reported suffering from a disease other than CKD to be more affected than those who had CKD alone.