Psychiatric disorders commonly co-exist with the diagnosis of chronic kidney disease (CKD). Research on depression and CKD has increased to a great extent. Multiple studies have demonstrated that depression is more prevalent in CKD and that end-stage renal disease is a robust risk factor for adverse outcomes such as hospitalization and mortality, yet these are often underdiagnosed or untreated. This review provides a selective overview on the prevalence rates of depression and anxiety in patients with CKD and across renal replacement therapies, the factors most consistently associated with symptoms of distress and their clinical implications. Finally, treatment and management strategies from relevant literature are appraised and discussed.

The study examined the role of illness perceptions and self-efficacy in diabetic regimen adherence and metabolic control among young patients with Insulin Dependent Diabetes Mellitus (IDDM). Sixty-four outpatients with Insulin Dependent Diabetes completed measures of illness perceptions, generalised and diabetes specific self-efficacy and a self-report measure of adherence. Metabolic control (HbAlc) was also assessed. Control, identity and consequences components of illness perceptions were significantly correlated with self-efficacy expectancies. Control beliefs were consistently associated with self-reported adherence across all treatment aspects and accounted for 39% of the predicted variance in total adherence. The associations of the other psychological predictors examined, varied depending on the regimen area. Multiple regression analysis showed that 30.8% of the variance in HbAlc assays was explained by patients' diabetes specific self-efficacy, consequences and identity. Our findings suggest that patients' beliefs are useful predictors of physiological and behavioural outcomes in diabetes self-management and should thus be the focus of routine clinical assessments and future interventions.

Kidney transplantation (TX) may ameliorate the neuropsychological (NP) impairments in end-stage renal disease (ESRD). Previous studies have suffered from small sample sizes, lack of standardization of dialysis adequacy, and insufficiently sensitive NP tests. Twenty-eight medically stable patients aged 44.04 (12.01) years with ESRD were investigated before and at 6 months after successful kidney TX using an NP test battery, which assessed attention-concentration, psychomotor ability and memory. Formal kinetic modelling of dialysis delivery ensured adequate renal replacement therapy. Transplant function was good on stable doses of immunosuppressive medication, without evidence of rejection at the time of testing. Within-subject comparisons showed statistically significant improvement in memory performance after kidney TX. Other NP measures (attention-concentration and psychomotor abilities) showed non-significant improvements. Normative comparisons showed NP impairments on dialysis, which were not apparent after TX. These data demonstrate improvements in cognition following kidney TX and emphasize the reversibility of the memory problems evidenced in dialysis.