END-STAGE RENAL DISEASE AND RENAL REPLACEMENT THERAPY: PSYCHOLOGICAL IMPACT ON CHILDREN: Research Article

Mohammed El. A. Zayed; Omer Saeed Magzoub

doi:10.58372/2835-6276.1026

Authors

Mohammed El. A. Zayed
Omer Saeed Magzoub

DOI:

https://doi.org/10.58372/2835-6276.1026

Keywords:

psychological impact, children, ESRD, renal replacement therapy

Abstract

End-stage renal disease (ESRD) is when kidney function has deteriorated to such a poor level that without renal replacement therapy (RRT), dialysis or transplantation, death is probable within weeks or months. While dialysis and renal transplantation are life-saving treatments, they are also demanding and impact appreciably on the everyday lives of ESRD patients, often negatively affecting emotional and psychological wellbeing.

This is a descriptive cross-sectional multi-center hospital-based study conducted during the period from October to December 2009 at Noora Children Center for Dialysis and Renal Transplant at Soba University Hospital and Dr. Salma Nephrology Center for Dialysis and Transplant, Khartoum, Sudan.

The objective was to study the psychological impact of end-stage renal disease (ESRD) and renal replacement therapy on children.

Results: The study included 77 children diagnosed with End Stage Renal Disease (ESRD) on renal replacement therapy. Children were at the age group 2 – 16 years. Male constituted 57.1% while females were 42.9% of the total study group. 38 (49.4%) were on Hemodialysis (HD), 20 (26%) were on Peritoneal Dialysis (PD) and 19 (24.6%) had renal transplantation. 49 (63.6%) of patients had increasing stress and worries, 67 (87%) had behavioral changes, 57 (74%) of patients had their schooling affected by the disease, all patients of ESRD 77 (100%) had mood changes. 57 (74%) become aggressive after the period of illness and 20 (26%) have no aggressive behavior. The vast majority of ESRD patients 60 (77.6%) became depressed after diagnosis. while 17 (22.4%) had no attacks of depression. Anxiety was present in 56 (72.7%) of patients while 21 (23.7%) had no anxiety. There was no much improvement in mood, aggression, depression or anxiety after starting dialysis unlike patient with renal transplant who showed good improvement in all aspects.

Conclusion: ESRD and renal replacement therapy has a negative psychological impact on children. There was a big difference between the dialysis and renal transplant in improving the behavioral status of patients. The majority of transplanted patient had good improvement in their behavioral status and psychological domain after transplantation and the minority of dialyzed patients had good improvement in their behavioral status and psychological domain.

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