In a new study, researchers found that psychiatric illnesses are common in children and adults with kidney failure.
They also found hospitalizations for such illnesses are linked to a higher risk of early death in adults.
The findings suggest that clinicians who care for hospitalized patients with kidney failure should be aware of and prepared to manage psychiatric disorders.
The research was conducted by a team from National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.
Previous research has shown that conditions such as depression and anxiety are common in children and adults with kidney failure, but the extent is unknown.
In the new study, the team examined hospitalizations with psychiatric diagnoses using inpatient claims from the first year of kidney failure in U.S. adults and children who initiated dialysis treatment from 1996-2013.
They found between 1996 and 2013, approximately 27% of adults (aged 22 to 64) and 21% of elderly adults (aged 65 and up) had hospitalizations with psychiatric diagnoses in the first year of kidney failure.
The prevalence was slightly lower in children, at 16%. Approximately 2% of adults and 1% of children were hospitalized with a primary psychiatric diagnosis.
The most common primary psychiatric diagnoses were depression/affective disorder in adults and children, and dementias in elderly adults.
The team also found the prevalence of hospitalizations with psychiatric diagnoses increased over time across age groups.
The rate of hospitalizations with psychiatric diagnoses increased from 9% in 1996—1998 to 26% in 2011-2013 for children, from 19% to 40% for adults, and from 17% to 39% in elderly adults.
The increases in prevalence rates were mostly from secondary diagnoses. A total of 19% of elderly adults, 25% of adults, and 15% of children were hospitalized with a secondary psychiatric diagnosis.
The team says doctors need to be aware of these findings and be prepared to address the needs of their patients.
It will be necessary to improve the understanding of the causes of psychiatric illness, the engagement of health professionals with psychiatric expertise, and the implementation of effective treatment strategies that are acceptable to patients.
The lead author of the study is Paul Kimmel, MD.
The study is published in CJASN.
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