Psychiatric Profile of Patients Currently Listed for Kidney Transplantation: Evidence of the Need for More Thorough Pretransplant Psychiatric Evaluations

Document Type

Article

Publication Date

12-1-2019

Publication Title

Transplantation proceedings

Abstract

BACKGROUND: Patients with end-stage renal disease are at increased risk for psychiatric and cognitive pathologies. Despite this, there is little standardization of the psychosocial and/or psychiatric evaluation of renal transplant candidates. The purpose of this study is to report the frequency of psychiatric and cognitive pathologies and corresponding psychiatric recommendations in a sample of patients actively listed for kidney transplant.

METHODS: We performed a retrospective chart review of 104 patients listed for kidney transplant who underwent semistructured psychiatric assessments as part of a novel clinical protocol. Transplant psychiatry routinely administers brief screeners of cognitive functioning and health literacy, also collected from patients' charts.

RESULTS: There were a number of primary psychiatric disorders, including active substance abuse. Even using a conservative cutoff, 52.4% of patients' charts indicated evidence of cognitive impairment, and 28.9% indicated limited health literacy. In addition, there were numerous additional recommendations made within every category (educational, psychotherapeutic/psychiatric, cognitive, cessation of substance use, substance abuse treatment, and mobilizing support for transplant). With the exclusion of the recommendation for more education regarding the transplant process, most patients had at least 1 to 3 recommendations (n = 72, 69.2%).

CONCLUSIONS: We have identified a number of concerning psychosocial and psychiatric factors in patients who were evaluated and listed for kidney transplantation that can adversely impact transplant outcomes. The findings provide support for more in-depth and ongoing psychiatric assessments as standard clinical protocol for kidney transplant candidates.

Medical Subject Headings

Adult; Female; Health Literacy; Humans; Kidney Failure; Chronic/complications/psychology; Kidney Transplantation/psychology; Male; Mental Disorders/complications/diagnosis; Middle Aged; Psychological Tests; Retrospective Studies; Substance-Related Disorders/complications

PubMed ID

31732207

ePublication

ePub ahead of print

Volume

51

Issue

10

First Page

3227

Last Page

3233

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