Depression and Cognitive Deficiency in Patients with Kidney Disease

Depression is the most common psychological complication in chronic kidney disease patients and plays a major role in treatment outcome. Depression is a significant risk factor for rehospitalization and death in these patients. It is important to note that a small number of these patients have adequate treatment, although the literature emphasises that combination of psychopharmacotherapy and psychotherapy is efficacious in reduction of depressive simptomatology. In addition to depression, a reciprocal relationship between cognitive deficit and renal dysfunction has been established in patients with renal insufficiency. It has been proven that about a third of these patients with end-stage renal disease meet the criteria for global cognitive impairment and that the severity of renal disease is directly related to the cognitive functioning of these patients. It is encouraging that hemodialysis treatment greatly improves and leads to stable cognitive status, although some degree of cognitive impairment remains constant. Renal failure, especially accompanied by depression and cognitive disfunction, has a serious impact on the quality of life in the final stages of the disease.