Psychological aspects of the management of chronic renal failure.

Cramond, W. A.; Knight, Peter R.; Lawrence, J. R.; Higgins, Bruce; Court, J. H.; MacNamara, F. M.; Clarkson, A. R.; Miller, Chloe

doi:10.1136/bmj.1.5591.539

Cited by 41 publications

(7 citation statements)

References 13 publications

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“…Banik et al, 1974;Menzies et al, 1968;De Nour et al, 1968;Crammond et al, 1968;Wilson et al, 1968), but little has been written on the effects of hemodialysis on children because of the relative newness of this application. As in other chronic diseases affecting children, one of the overriding emotional factors for the child is the uncertainty that will dominate the many years of life ahead.…”

Section: Psychological Management and Renal Dialysis Phyllis R Magrabmentioning

confidence: 96%

Psychological management and renal dialysis

Magrab

1975

Journal of Clinical Child Psychology

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Section: Psychological Management and Renal Dialysis Phyllis R Magrabmentioning

confidence: 96%

Psychological management and renal dialysis

Magrab

1975

Journal of Clinical Child Psychology

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“…With the patient coming to the dialysis unit twice weekly for fifteen hours the remainder of his life, intense transference and countertransference reactions develop. (De- Nour, 1968;Cramond et al, 1968) both discuss this area and the problems of possessiveness and withdrawal which occur in nurses and patients. Nurses are frequently frustrated by the patient who will not let them take care of him, the patient who becomes demanding, or the negativistic patient.…”

Section: Interpersonal Relationsmentioning

confidence: 97%

Survival by Machine: The Psychological Stress of Chronic Hemodialysis

Abram

1970

Psychiatry in Medicine

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The prolongation of life by artificial means is a compelling topic for the physician who treats patients with chronic hemodialysis. This paper discusses the stresses, losses, and restrictions which dialysis imposes upon the patient, his family, and other caretakers. Examples of psychological reactions to such circunistances are given and major conflictual problems are described. The role of dependency and independence in chronic illness, the use of denial as a major defense mechanism, alterations in body image, attitudes towards life and death are all discussed in terms of the psychological reactions to the stress of hemodialysis. The problem of suicide is illustrated with a variety of forms it takes in these special patients who depend upon mechanical devices for their very existence. Some of the moral, ethical and economic problems of patient selection for hemodialysis are indicated and briefly examined.

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“…Tricyclic antidepressants seem to be indicated in some cases (Cramand et al, 1968;Levy, 1976), but the response to treatment has not been investigated systematically (Czaczkes & De Nour, 1978). Our clinical impres-sion, like that of others (Buchanan etal., 1977), is that the response is often disappointing.…”

Section: Introductionmentioning

confidence: 99%

The pharmacokinetics of nortriptyline in patients with chronic renal failure.

Dawlilng¹,

Lynn²,

Rosser³

et al. 1981

Brit J Clinical Pharma

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1 The pharmacokinetics of single oral doses of nortriptyline were studied in twenty patients with chronic renal failure, eight of whom were receiving treatment with haemodialysis. 2 The median nortriptyline half‐life was 25.2 h (range 14.5‐140.0 h) and the median nortriptyline clearance was 32.3 l/h (range 8.1‐122.0 l/h). 3 No differences were observed between the dialysed and non‐dialysed groups. 4 Comparisons of nortriptyline half‐life and clearance between the patients and groups of physically healthy subjects revealed no significant differences. 5 There was no significant linear correlation between age and either of these measurements. In the twelve patients not receiving haemodialysis there was no correlation between nortriptyline clearance and glomerular filtration rate. 6 Chronic renal failure is not associated with a significant alteration in nortriptyline metabolism as measured by its half‐life or clearance, but the drug should nonetheless be used with caution, and monitored whenever possible. However, the marked inter‐ individual differences observed in nortriptyline half‐life and clearance in patients with chronic renal failure may not be solely responsible for their unpredictable response to tricyclic antidepressant therapy, and other possible contributory factors are discussed.

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Psychological aspects of the management of chronic renal failure.

Cited by 41 publications

References 13 publications

Psychological management and renal dialysis

Psychological management and renal dialysis

Survival by Machine: The Psychological Stress of Chronic Hemodialysis

The pharmacokinetics of nortriptyline in patients with chronic renal failure.

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