Lviv clinical bulletin 2013, 3(3): 14-17

https://doi.org/10.25040/lkv2013.03.014

Some Peculiarities of Psycho-Emotional Changes in Patients with Renal Encephalopathy

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V. Shevaga, A. Payenok, A. Zadorozhnyj, B. Zadorozhna

Danylo Halytsky Lviv National Medical University

Introduction. Today, doctors in general practice observe the steady growth of chronic diseases of the internal organs, which lead to violations of the normal functioning of the central nervous system with the gradual emergence of encephalopathy. Metabolic encephalopathies include brain damage due to homeostasis disorders in organs in the case of chronic kidney disease. However, the appearance of renal encephalopathy provokes not only toxic and metabolic disorders, but also arterial hypertension, which is a companion of chronic kidney disease.

Aim. To study the psycho-emotional changes in patients with renal encephalopathy by the standardized multivariate personality examination (SMPE).

Materials and methods. 20 patients with renal encephalopathy were examined, among them 8 men (40.0%) and 12 women (60.0%) aged from 24 to 43 years (serum age 38.73 ± 0.76). According to ICD-10, chronic kidney disease stage I was in 5 (25.0%) of the examined patients with renal encephalopathy, stage II – in 8 (40.0%), III – in 4 (20.0%), and IV – in 3 (15.0%). The control group was made of 22 practically healthy persons of the corresponding age. For a quantitative and qualitative assessment of changes of the psycho-emotional sphere of patients with renal encephalopathy, the SMPE method, being the Minnesota Multiphasic Personality Inventory (MMPI) and adapted by L. N. Sobchik to our conditions, was used.

Results. A floating profile of Minnesota Multiphasic Personality Inventory was found in the examined patients in which most scales were above the upper limit of standard. The studied profile signifies the state of general stress which involves different mechanisms and compensatory functions of psychic activity which are under the tension. These are directed for the discrimination of dysadaptation. Although with this profile mental tension increases, this prognostic profile is promising in terms of normalization, as in this case a psychogenic borderline conditions caused by chronic somatic diseases are observed.

In particular, the increased level of anxiety, uncertainty in oneself, the concentration of negative experiences, the presence of affective perversity of manifestations of inhibition and psychoasthenic response to external stimuli within the limits of neurotic disorders in the surveyed testify the high level of scores on the scale 6 and 7 in comparison with the control group (p <0.05).

The presence of health problems in the patients with nephrotic encephalopathy and the absence of significant co-participation and help from others causes their autisation, the separation from reality (scale 8) (p <0.05 comparatively with a control group).

Conclusions. Patients with renal encephalopathy often have anxiety-asthenic syndrome, and therefore such patients need the social support, which will facilitate their return to normal, active daily life.

References

  1. Kutyrina IM, Martynov SA, Shvetsov MY, et al. Arterial Hypertension in Chronic Glomerulonephritis: the Frequency of Detection and the Effectiveness of Treatment. Therapeutic Archive. 2004; 9: 10-15. (Russian)
  2. Vinychuk SM. Metabolic Encephalopathy: Pathophysiology, Clinics, Treatment. Art of Treatment. 2004; 9: 92-95. (Ukrainian)
  3. Voynarovska NY. Clinical Features of Encephalopathy of Renal Origin. Abstracts of the 3rd International Congress of Students and Young Scientists. Ternopil: Ukrmedkniga, 1999. p. 17-18 (Ukrainian)
  4. Mukhin NA. Tubulointerstitial nephritis and Arterial Hypertension. Nephrology 2000; 4 (1): 109-111. (Russian)
  5. Sobchyk LN. Standardized Multifactorial Method of Personality Research: method. guidance. Series “Methods of Psychological Diagnostics”. Moscow, 1990. 78 p. (Russian)
  6. Mukhin NA, Balkarov IM, Moiseev SV, et al. Chronic Progressive Nephropathies and Lifestyle of a Modern Person. Therapeutic Archive. 2004; 9: 5-10. (Russian)
  7. Shtulman DR, Levin OS. Neurology: A Practitioner’s Guide. 5th ed. Moscow: MEDpress-inform, 2007. 960 p. (Russian)
  8. Maschio G. How good are nephrologists at controlling blood pressure in renal patients? Nephrol Dial Transplant. 1999;14(9):2075-2077. https://doi.org/10.1093/ndt/14.9.2075
  9. Ridao N, Lu-o J, García de Vinuesa S, Gómez F, Tejedor A, Valderrábano F. Prevalence of hypertension in renal disease. Nephrol Dial Transplant. 2001;16(1 Suppl):70-73. https://doi.org/10.1093/ndt/16.suppl_1.70