Psychological Aspects of Chronic-Maintenance Hemodialysis Patients

  • Phillip J. Brantley
  • Polly B. Hitchcock
Part of the Springer Series in Rehabilitation and Health book series (SSRH)


End-stage renal disease (ESRD) is a condition involving irreversible failure of excretory and regulatory functions of the kidneys. As ESRD progresses, residual renal function can no longer sustain normal body functioning, and survival is impossible without some form of renal replacement therapy (Eknoyan, 1991). ESRD remained virtually untreatable and often resulted in death until the early 1960s, when hemodialysis treatment began prolonging life (Norton, 1982). Although suitable for only a few patients, renal transplantation and peritoneal dialysis can preclude the more prevalent ESRD treatment, chronic-maintenance hemodialysis (Wauters, Hunziker, & Brunner, 1983). Congress began funding hemodialysis treatment in 1972, thereby increasing its availability to ESRD patients, many of whom until then did not qualify for treatment based on their “social worth” (Kutner & Brogan, 1990). Medical advances continue to increase longevity, reduce infection risk, and improve hemodialysis procedures; however, the intrusive nature of this process can result in difficulty adjusting to maintenance hemodialysis. The lifestyle accompanying hemodialysis requires compliance with a complex and strict treatment regimen. For this reason, psychological problems associated with this regimented lifestyle have arisen, including depression, anxiety, neuropsychological complications, noncompliance, and marital difficulties. Psychologists began addressing these issues and integrating into teams of treatment professionals in the early 1970s (Kirschenbaum, 1991). Health psychologists, in particular, have become involved in efforts to improve patient adherence to medical procedures and improve quality of life for hemodialysis patients. This chapter discusses ESRD., its prevalence, complications, and treatment, and psychological issues associated with chronic-maintenance hemodialysis.


Sexual Dysfunction Dialysis Patient Hemodialysis Patient ESRD Patient Continuous Ambulatory Peritoneal Dialysis 
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Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Phillip J. Brantley
    • 1
  • Polly B. Hitchcock
    • 2
  1. 1.Department of Family MedicineLouisiana State University Medical CenterBaton RougeUSA
  2. 2.Department of PsychologyLouisiana State UniversityBaton RougeUSA

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