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Polypharmacy and Mental Health Issues in the Senior Hemodialysis Patient

Hemodialysis (HD) is the most common method of chronic kidney failure (CKF) treatment, with 65% of European patients with CKF receiving HD in 2018. Regular two to three HD sessions weekly severely lower their quality of life, resulting in a higher incidence of depression and anxiety, which is presen...

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Autores principales: Knehtl, Maša, Petreski, Tadej, Piko, Nejc, Ekart, Robert, Bevc, Sebastjan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133494/
https://www.ncbi.nlm.nih.gov/pubmed/35633796
http://dx.doi.org/10.3389/fpsyt.2022.882860
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author Knehtl, Maša
Petreski, Tadej
Piko, Nejc
Ekart, Robert
Bevc, Sebastjan
author_facet Knehtl, Maša
Petreski, Tadej
Piko, Nejc
Ekart, Robert
Bevc, Sebastjan
author_sort Knehtl, Maša
collection PubMed
description Hemodialysis (HD) is the most common method of chronic kidney failure (CKF) treatment, with 65% of European patients with CKF receiving HD in 2018. Regular two to three HD sessions weekly severely lower their quality of life, resulting in a higher incidence of depression and anxiety, which is present in one third to one half of these patients. Additionally, the age of patients receiving HD is increasing with better treatment and care, resulting in more cognitive impairment being uncovered. Lastly, patients with other mental health issues can also develop CKF during their life with need for kidney replacement therapy (KRT). All these conditions need to receive adequate care, which often means prescribing psychotropic medications. Importantly, many of these drugs are eliminated through the kidneys, which results in altered pharmacokinetics when patients receive KRT. This narrative review will focus on common issues and medications of CKF patients, their comorbidities, mental health issues, use of psychotropic medications and their altered pharmacokinetics when used in HD, polypharmacy, and drug interactions, as well as deprescribing algorithms developed for these patients.
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spelling pubmed-91334942022-05-27 Polypharmacy and Mental Health Issues in the Senior Hemodialysis Patient Knehtl, Maša Petreski, Tadej Piko, Nejc Ekart, Robert Bevc, Sebastjan Front Psychiatry Psychiatry Hemodialysis (HD) is the most common method of chronic kidney failure (CKF) treatment, with 65% of European patients with CKF receiving HD in 2018. Regular two to three HD sessions weekly severely lower their quality of life, resulting in a higher incidence of depression and anxiety, which is present in one third to one half of these patients. Additionally, the age of patients receiving HD is increasing with better treatment and care, resulting in more cognitive impairment being uncovered. Lastly, patients with other mental health issues can also develop CKF during their life with need for kidney replacement therapy (KRT). All these conditions need to receive adequate care, which often means prescribing psychotropic medications. Importantly, many of these drugs are eliminated through the kidneys, which results in altered pharmacokinetics when patients receive KRT. This narrative review will focus on common issues and medications of CKF patients, their comorbidities, mental health issues, use of psychotropic medications and their altered pharmacokinetics when used in HD, polypharmacy, and drug interactions, as well as deprescribing algorithms developed for these patients. Frontiers Media S.A. 2022-05-12 /pmc/articles/PMC9133494/ /pubmed/35633796 http://dx.doi.org/10.3389/fpsyt.2022.882860 Text en Copyright © 2022 Knehtl, Petreski, Piko, Ekart and Bevc. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Knehtl, Maša
Petreski, Tadej
Piko, Nejc
Ekart, Robert
Bevc, Sebastjan
Polypharmacy and Mental Health Issues in the Senior Hemodialysis Patient
title Polypharmacy and Mental Health Issues in the Senior Hemodialysis Patient
title_full Polypharmacy and Mental Health Issues in the Senior Hemodialysis Patient
title_fullStr Polypharmacy and Mental Health Issues in the Senior Hemodialysis Patient
title_full_unstemmed Polypharmacy and Mental Health Issues in the Senior Hemodialysis Patient
title_short Polypharmacy and Mental Health Issues in the Senior Hemodialysis Patient
title_sort polypharmacy and mental health issues in the senior hemodialysis patient
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9133494/
https://www.ncbi.nlm.nih.gov/pubmed/35633796
http://dx.doi.org/10.3389/fpsyt.2022.882860
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