Management of Depression in Dialysis Patients

  • Jon Streltzer


While depression seems to be the most common psychiatric complication of end stage renal disease (ESRD),(1) reports of treatment are few and primarily anecdotal. Recommendations for treatment generally include psychotherapeutic support and psychiatric liaison activities such as providing support to nursing staff and guiding nurses and physicians in their interactions with dialysis patients.(2) While tricyclic antidepressant medications have been recommended in dialysis populations, reports of their use are rare and there are no controlled studies. Rosser(3) reported measurements of plasma antidepressant levels in three dialysis patients. Each patient had unusually high plasma levels relative to their small oral doses. One patient demonstrated excellent recovery and a second patient had partial recovery. The third patient died from a cardiac arrhythmia possibly induced by the antidepressant medication. Thus, there are no clear guidelines to help determine the benefits and risks of tricyclic antidepressants in a dialysis population.


Depressive Symptom Dialysis Patient Depressed Mood Major Depressive Episode Adjustment Disorder 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Psychiatric Association: Diagnostic and statistical manual of mental disorders, third edition ( American Psychiatric Association, Washington, 1980 ).Google Scholar
  2. Czaczkes, J.W., and De-Nour, A.K. Chronic hemodialysis as a way of life ( Brunner/hazel, New York, 1978 ), p. 111.Google Scholar
  3. Klein, D.F. Endogenomorphic depression. Archives of General Psychiatry 31: 447–454 (1974).PubMedCrossRefGoogle Scholar
  4. Lowry, M.R. Frequency of depressive disorder in patients entering home hemodialysis. The Journal of Nervous and Mental Disease 164: 199–204 (1979).CrossRefGoogle Scholar
  5. McCabe, M.S., and Corry, R.J. Psychiatric illness and human renal transplantation. J. Clin. Psychiatry 39: 393–400 (1978).Google Scholar
  6. McCabe, M.S., and Corry, R.J. Psychiatric illness and human renal transplantation. J. Clin. Psychiatry 39: 393–400 (1978).Google Scholar
  7. Plumb, M.M., and Holland, J. Comparative studies of psychological function in patients with advanced cancer-I: self-reported depressive symptoms. Psychosomatic Medicine 39: 264–276 (1977).PubMedGoogle Scholar
  8. Reichsman, R., and McKegney, F.P. Psychosocial aspects of maintenance hemodialysis. In: Strategy in renal failure, E.A. Friedman, ed. ( John Wiley and Sons, Inc., New York, 1978 ).Google Scholar
  9. Rhodes, L.M. Social climate perception and depression of patients and staff in a chronic hemodialysis unit. The Journal of Nervous and Mental Disease 169:169–175 (1981)Google Scholar
  10. Rosser, R. Depression during renal dialysis and following trans- plantation. Proc. Roy. Soc. Med. 69: 832–834 (1976).Google Scholar
  11. Streltzer, J., Markoff, R.A., and Yano, B. Maintenance hemodialysis in patients with severe pre-existing psychiatric disorders. The Journal of Nervous and Mental Disease 164: 414–418 (1977).PubMedCrossRefGoogle Scholar
  12. Yanagida, E.H., and Stretlzer, J. Limitations of psychological tests in a dialysis population. Psychosomatic Medicine 41: 557–567 (1979).PubMedGoogle Scholar

Copyright information

© Plenum Press, New York 1983

Authors and Affiliations

  • Jon Streltzer
    • 1
  1. 1.Department of Psychiatry and Institute of Renal Diseases St. Francis HospitalJohn A. Burns School of MedicineHonolulu, HawaiiUSA

Personalised recommendations