Neuropsychiatric disorders and renal diseases: an update

INTRODUCTION

The psychiatric disorders associated with kidney disease take many forms, depending on the natural history of the disease. Classically, uremia has been cited as the cause of delirium.1 Symptoms such as somnolence and psychomotor agitation may be present among the clinical signs of acute kidney injury (AKI).2 Drug regimens should also be considered as a potential source of psychiatric disorders. Steroids and cyclosporine, used in the treatment of various glomerulopathies and administered subsequently to renal transplantation, have been associated with depression, mania and psychotic symptoms.3

As in every chronic condition, patients with chronic kidney disease (CKD) may suffer from limited functional capacity, impaired productivity, and reduced quality of life.4 Psychiatric disorders are highly prevalent in patients with CKD. Kimmel et al.5 showed that patients with CKD had to be hospitalized for psychiatric disorders (particularly depression, dementia, and substance abuse) 1.5 to three times more than individuals with other chronic diseases. Yet, they are still underdiagnosed and undertreated.6

This paper discusses some of the neuropsychiatric disorders often associated with kidney disease.

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