Key result
Dialysis in patients with end-stage kidney disease is associated with a higher than expected risk of self-harm, particularly in those suffering from depression and anxiety.
Why the study?
Is there a relationship between dialysis and suicide in patients with ESKD?
Systematic Review
Is there a relationship between dialysis and suicide in patients with ESKD?
Dialysis patients, particularly those with comorbid depression and anxiety, appear to have a higher than expected risk of self-harm and suicide.
Answers are grounded in this paper and cite their sources.
Alerts clinicians to elevated self-harm risk in dialysis patients with mood disorders; leaves open whether targeted interventions reduce suicide rates.
BACKGROUND: Studies have shown that patients with end-stage kidney disease (ESKD) are at risk of experiencing suicidal ideation and suicide attempt. STUDY DESIGN: The aim of the present review was to investigate whether there was a relationship between dialysis and suicide. A careful systematic review of the literature was conducted to determine the potential association between dialysis and suicide. SELECTION CRITERIA FOR STUDIES: Abstracts that did not explicitly mention suicide and dialysis were excluded. We identified as specific fields of interest in the analysis of dialysis or ESRD and suicidal behavior. RESULTS: A total of 26 articles from peer-reviewed journals were considered and the most relevant articles (N = 13) were selected for this review. OUTCOMES: It has been posited that suicidal ideation, occurring in dialysis, may arise from co-morbid depression and psychiatric symptoms are frequent in patients who underwent dialysis. LIMITATIONS: The present review should be considered in the light of some limitations. We did not carry out a meta-analysis because data from most of the studies did not permit it. Samples included different measurements and different outcomes, and they assessed patients at different time points. CONCLUSIONS: The available data suggest that the risk of self-harm may be higher than expected in dialysis patients especially in those who suffer by depression and anxiety. Moreover, although the majority of deaths among dialysis patients is preceded by withdrawal from treatment, suicide remains a separate phenomenon.
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Pompili et al. (2013) conducted a systematic review in End-stage kidney disease (ESKD). Dialysis was evaluated on Suicidal ideation and suicide attempt. Dialysis in patients with end-stage kidney disease is associated with a higher than expected risk of self-harm, particularly in those suffering from depression and anxiety.
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