부산대학교 도서관

Background: Depression is a co-morbidity whose identifi cation and intervention can be vital in chronic kidney failure. Case report: 36-year- old male patient was brought to ER with palpitation. He had been diagnosed with chronic kidney failure for 9 months and on dialysis for 6 months. Physical examination showed 220/minutes HR and ECG tachycardia with high T waves, broad QRS and P wave, prolonged PR distance which were consistent with severe hyperkalemia. His K level was 9.55 mEq/L and received an emergency dialysis. Control ECG was normal and K level was 4.86 mEq/L. The reason for fatal increase in K level was overconsumption of apricots. He didn`t follow his diet although warned at dialysis sessions. He was given education about his diet again. The following day, his K level was 7.48 mEq/L and received another emergency dialysis. He`d been eating grapes aware of the consequences. The patient was on dialysis in 3 months after his diagnosis and lost his job because of his dialysis sessions and was still unemployed. He had socioeconomical problems and learned that overconsumption of fruits could kill him. In the light of those fi ndings; he was considered to have major depression with suicidal ideation and was emergently referred to a psychiatry clinic for observation and treatment. Conclusion: Chronic kidney failure consists many physical and psychological problems. Dialysis patients depend on machines, invasive procedures and health workers, generally cannot keep a full time job. There is also a serious food and drink restriction. Thus; depression is common and there is a higher suicide rate. Still; depression is underdiagnosed and undertreated in dialysis patients. To check dialysis patients for depression signs and start therapy if needed will improve the quality of life and prevent possible suicide attempts.