الفهرس 
CHRONIC RENAL FAILUREOnly 14 pages are availabe for public view
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Abstract
T
he objective of this work was to study the frequency, possible causes and consequences of psychological disorders in children and adolescents with chronic renal failure on regular hemodialysis. For this purpose, 50 pediatric patients with chronic renal failure on regular hemodialysis (3 times weekly) were studied.
Results of our study showed that 35 patients (70%) had depression, of these 24 patients (48%) had mild degree of depression, 10 patients (20%) had moderate degree of depression and 1 patient (2%) had severe degree of depression.
All studied cases suffered from anxiety, 3 patients (6%) had mild anxiety, 27 patients (54%) had moderate anxiety and 20 patients (40%) had severe anxiety. All depressed patients showed associated different degrees of anxiety.
Our results showed that there was no statistically significant association between gender and degree of depression, however, female gender was significantly associated with higher degrees of anxiety.
Twelve of the studied children (24%) were on regular hemodialysis for one year or less while thirty eight children (76%) were on regular hemodialysis for more than one year. There was no statistically significant association between duration of hemodialysis and degree of comorbid depression or anxiety.
Forty three of the studied children (86%) were of low social standard and seven (14%) were of moderate social standard. Children with low social standard showed no significant difference in the degree of associated depression or anxiety compared to children of moderate social standard.
In the present study, only three patients (6%) had never joined school, fifteen patients (30%) discontinued education and thirty two patients (64%) were still at school. No statistically significant association was demonstrated between educational level and degree of depression or anxiety.
There was no statistically significant association between degree of depression or anxiety and the biochemical parameters including blood urea, serum creatinine, serum calcium and phosphorus concentrations as well as serum albumin and Hb.
Twelve of the studied cases (24%) were noncompliant to treatment. Our results demonstrated no statistically significant association between compliance to treatment and degree of comorbid depression or anxiety.
Results of the present work revealed that 4 patients (8%) showed an aggressive behavior while 6 patients (12%) showed social isolation. We were unable to demonstrate any statistically significant relation between degree of depression or anxiety and social isolation or aggression.
A low self esteem was present in 27 patients (54%). Hemodialysis children with low self esteem had significantly higher degrees of depression compared to those with normal self esteem. However, the degree of anxiety was not significantly affected by the presence of low self esteem.
Seventeen of the studied children (34%) had sleep disorders. Hemodialysis children with sleep disorders showed significantly higher degrees of depression or anxiety compared to those without sleep disorders.
Only one of the studied cases (2%) had suicidal thoughts. This patient suffered from associated severe depression and severe anxiety. A statistically significant association was demonstrated between suicidal tendency and degree of depression, but no association was detected between suicidal tendency and degree of anxiety.