Zaburzenia neuropsychiczne u chorych z przewlekłą chorobą nerek ze szczególnym uwzględnieniem autosomalnie dominującej wielotorbielowatości nerek Artykuł przeglądowy
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Opublikowane:
gru 31, 2018
Słowa kluczowe:
ADPKD, zaburzenia psychiczne, przewlekła choroba nerek, depresja, zaburzenia lękowe
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Abstrakt
Zaburzenia psychiczne często towarzyszą pacjentom cierpiącym z powodu różnych somatycznych chorób przewlekłych, co w szczególnym stopniu dotyczy przewlekłej choroby nerek. Rodzaj i nasilenie zaburzeń zależą od stopnia zaawansowania choroby, jej powikłań, chorób współistniejących oraz przyjmowanych przez pacjenta leków. Część zaburzeń, takich jak majaczenie, omamy czy cechy encefalopatii mocznicowej, występuje przede wszystkim u chorych ze schyłkową niewydolnością nerek. Inne częste zaburzenia, takie jak depresja i zaburzenia lękowe, pojawiają się na każdym etapie choroby, jednak z największą częstością u chorych poddawanych terapii nerkozastępczej. Wśród przyczyn przewlekłej choroby nerek na szczególną uwagę zasługuje autosomalnie dominująca wielotorbielowatość nerek ze względu na częstość jej występowania, dziedziczny charakter i związany z nią wysoki na tle innych przyczyn przewlekłej choroby nerek odsetek towarzyszących chorób psychicznych. Mimo częstego współwystępowania depresji, zaburzeń lękowych oraz innych chorób pozostających w kręgu zainteresowań psychiatrii wciąż odsetek chorych nefrologicznych, u których rozpoznano zaburzenie psychiczne oraz rozpoczęto jego leczenie, jest w tej populacji stosunkowo niewielki. W niniejszym artykule omawiamy najczęstsze zaburzenia psychiczne występujące u chorych z przewlekłą chorobą nerek, ich wpływ na leczenie i rokowanie, ze szczególnym uwzględnieniem autosomalnie dominującej wielotorbielowatości nerek.
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Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa – Użycie niekomercyjne – Bez utworów zależnych 4.0 Międzynarodowe.
Copyright: © Medical Education sp. z o.o. License allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
Bibliografia
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2. Kimmel PL, Thamer M, Richard CM, Ray NF. Psychiatric illness in patients with end-stage renal disease. Am J Med 1998; 105(3): 214-221.
3. Cukor D, Coplan J, Brown C et al. Depression and anxiety in urban hemodialysis patients. Clin J Am Soc Nephrol 2007; 2: 484-490.
4. Pérez Domínguez TS, Buset Rios N, Rodriguez Esparragon F et al. Psychonephrology: Psychological aspects in autosomal dominant polycistic kidney disease. Nefrologia 2011; 31(6): 716-722.
5. Finkelstein FO, Finkelstein SH. Depression in chronic dialysis patients: assessment and treatment. Nephrol Dial Transplant 2000; 15: 1911-1913.
6. Waraich P, Goldner EM, Somers JM et al. Prevalence and incidence studies of mood disorders: a systematic review of the literature. Can J Psychiatry 2004; 49: 124-138.
7. Cohen SD, Norris L, Acquaviva K et al. Screening, diagnosis, and treatment of depression in patients with end-stage renal disease. Clin J Am Soc Nephrol 2007; 2: 1332-1342.
8. Katon WJ. Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues Clin Neurosci 2011; 13: 7-23.
9. Joynt KE, Whellan DJ, O’Connor CM. Depression and cardiovascular disease: mechanisms of interaction. Biol Psychiatry 2003; 54: 248-261.
10. Frasure-Smith N, Lespérance F, Habra M et al. Atrial Fibrillation and Congestive Heart Failure Investigators. Elevated depression symptoms predict long-term cardiovascular mortality in patients with atrial fibrillation and heart failure. Circulation 2009; 20: 134-140.
11. Burton HJ, Kline SA, Lindsay RM et al. The relationship of depression to survival in chronic renal failure. Psychosom Med 1986; 48: 261-269.
12. Arapaslan B, Soykan A, Soykan C et al. Cross-sectional assessment of psychiatric disorders in renal transplantation patients in Turkey: a preliminary study. Transplantation Proceedings 2004; 36: 1419-1421.
13. Saglimbene V, Palmer S, Scardapane M et al. Depression and allcause and cardiovascular mortality in patients on haemodialysis: a multinational cohort study. Nephrol Dial Transplant 2017; 32(2): 377-384.
14. Hedayati SS, Bosworth HB, Briley LP et al. Death or hospitalization of patients on chronic hemodialysis is associated with a physician-based diagnosis of depression. Kidney Int 2008; 74: 930-936.
15. Palmer S, Vecchio M, Craig JC et al. Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies. Kidney Int 2013; 84: 179-191.
16. Abdel-Kader K, Unruh ML, Weisbord SD. Symptom burden, depression, and quality of life in chronic and end-stage kidney disease. Clin J Am Soc Nephrol 2010; 5(9): 1566-1573.
17. Panagopoulou A, Hardalias A, Berati S, Fourtounas C. Psycho-social issues and quality of life in patients on renal replacement therapy. Saudi J Kidney Dis Transpl 2009; 20: 212-218.
18. Masoumi M, Naini AE, Aghaghazvini R et al. Sleep quality in patients on maintenance hemodialysis and peritoneal dialysis. Int J Prev Med 2013; 4: 165-172.
19. Griffin KW, Wadhwa NK, Friend R, Suh H, Howell N, Cabralda T et al. Comparison of quality of life in hemodialysis and peritoneal dialysis patients. Adv Perit Dial 1994; 10: 104-108.
20. Watnick S, Kirwin P, Mahnensmith R, Concato J. The prevalence and treatment of depression among patients starting dialysis. Am J Kidney Dis 2003; 41(1): 105-110.
21. Smith MD, Hong BA, Robson AM: Diagnosis of depression in patients with end-stage renal disease. Comparative analysis. Am J Med. 1985; 79: 160-166.
22. Grant D, Almond MK, Newnham A et al. The Beck Depression Inventory requires modification in scoring before use in a haemodialysis population in the UK. Nephron Clin Pract 2008; 110: 33-38.
23. Theofilou PA. Sexual functioning in chronic kidney disease: the association with depression and anxiety. Hemodial Int 2012; 16(1): 76-81.
24. Song MK, Ward SE, Hladik GA et al. Depressive symptom severity, contributing factors, and self-management among chronic dialysis patients. Hemodial Int 2016; 20: 286-292.
25. Di Lullo L, Rivera R, Barbera V et al. Sudden cardiac death and chronic kidney disease: from pathophysiology to treatment strategies. Int J Cardiol 2016; 217: 16-27.
26. Cukor D, Rosenthal DS, Jindal RM et al. Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients. Kidney Int 2009; 75: 1223-1229.
27. Koo JR, Yoon JW, Kim SG et al. Association of depression with malnutrition in chronic hemodialysis patients. Am J Kidney Dis 2003; 41: 1037-1042.
28. Kimmel PL, Peterson RA. Depression in end stage renal disease patients: Tools, correlates, outcomes and needs. Semin Dial 2005; 18: 91-97.
29. Kimmel PL, Peterson RA, Weihs KL et al. Multiple measurements of depression predict mortality in a longitudinal study of chronic hemodialysis outpatients. Kidney Int 2000; 57: 2093-2098.
30. Kurella M, Kimmel PL, Young BS et al. Suicide in the United States end-stage renal disease program. J Am Soc Nephrol 2005; 16: 774-781.
31. Walters BA, Hays RD, Spritzer KL et al. Health-related quality of life, depressive symptoms, anemia, and malnutrition at hemodialysis initiation. Am J Kidney Dis 2002; 40: 1185-1194.
32. Rizk D, Jurkovitz C, Veledar E et al. Quality of life in autosomal dominant polycystic kidney disease patients not yet on dialysis. Clin J Am Soc Nephrol 2009; 43: 560-566.
33. Miskulin DC, Abebe KZ, Chapman AB et al. Health-related quality of life in patients with autosomal dominant polycystic kidney disease and CKD stages 1-4: a cross-sectional study. Am J Kidney Dis 2014; 63: 214-226.
34. Suwabe T, Ubara Y, Mise K et al. Quality of life of patients with ADPKD-Toranomon PKD QOL study: cross-sectional study. BMC Nephrol 2013; 14: 179.
35. Simms RJ, Thong KM, Dworschak GC et al. Increased psychosocial risk, depression and reduced quality of life living with autosomal dominant polycystic kidney disease. Nephrology Dialysis Transplantation 2016; 31(7): 1130-1140.
36. Nagler EV, Webster AC, Vanholder R et al. Antidepressants for depression in stage 3-5 chronic kidney disease: a systematic review of pharmacokinetics, efficacy and safety with recommendations by European Renal Best Practice (ERBP). Nephrol Dial Transplant 2012; 27(10): 3736-3745.
37. Care A, DiMartini C, Crone M et al. Psychiatric aspects of organ transplantation in critical care. Crit Care Clin 2008; 24(4): 949-981.
38. Fischer MJ, Xie D, Jordan N et al. Factors associated with depressive symptoms and use of antidepressant medications among participants in the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC Studies. Am J Kidney Dis 2012; 60: 27-38.
39. Lopes AA, Albert JM, Young EW et al. Screening for depression in hemodialysis patients: associations with diagnosis, treatment, and outcomes in the DOPPS. Kidney Int 2004; 66: 2047-2053.
40. Nagler EV, Webster AC, Vanholder R et al. Antidepressants for depression in stage 3-5 chronic kidney disease: a systematic review of pharmacokinetics, efficacy and safety with recommendations by European Renal Best Practice (ERBP). Nephrol Dial Transplant 2012; 27: 3736-3745.
41. Eyler RF, Unruh ML, Quinn DK et al. Psychotherapeutic agents in end-stage renal disease. Semin Dial 2015; 28: 417-426.
42. Cohen LM, Levy NB, Tessier EG et al. W: Levenson JL (red). The American Psychiatric Publishing textbook of psychosomatic medicine. 1st ed. Washington: American Psychiatric Publishing 2005: 483-490.
43. Cukor D, Coplan J, Brown C et al. Course of depression and anxiety diagnosis in patients treated with hemodialysis: a 16-month follow-up. Clin J Am Soc Nephrol 2008; 3: 1752-1758.
44. Moreira JM, da Matta SM, Melo e Kummer A et al. Neuropsychiatric disorders and renal diseases: an update. J Bras Nefrol 2014; 36(3): 396-400.
45. Bandelow B, Sher L, Bunevicius R et al. WFSBP Task Force on Mental Disorders in Primary Care; WFSBP Task Force on Anxiety Disorders, OCD and PTSD. Guidelines for the pharmacological treatment of anxiety disorders, obsessive-compulsive disorder and posttraumatic stress disorder in primary care. Int J Psychiatry Clin Pract 2012; 16: 77-84.
46. Morrison G, Chiang ST, Kopke HH et al. Effect of Renal Imparement on Hemodialysis on lorazepam kinetics. Clin Pharmacol Ther 1984; 35(5): 646-652.
47. Kulesza A, Niemczyk M, Gradzik M. Intracranial Manifestations of Autosomal Dominant Polycystic Kidney Disease. Int J Neurol Res 2016; 2(1): 210-215.
48. Pirson Y, Chauveau D, Torres V. Management of cerebral aneurysms in autosomal dominant polycystic kidney disease. J Am Soc Nephrol 2002; 13(1): 269-277.
49. Thompson BG, Brown RD Jr, Amin-Hanjani S et al. Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2015; 46(8): 2368-2400.
50. Menghini VV, Brown RD Jr, Sicks JD et al. Incidence and prevalence of intracranial aneurysms and hemorrhage in Omsted County, Minnesota 1965 to 1995. Neurology 1998; 51: 405-411.
51. Rinkel GJE. Intracranial aneurysm screening: indications and advice for practice. Lancet Neurology 2005; 4: 122-128.
52. Pirson Y. Extrarenal manifestations of autosomal dominant polycystic kidney disease. Adv Chronic Kidney Dis 2010; 17: 173-180.
53. Niemczyk M, Gradzik M, Niemczyk S et al. Intracranial aneurysms in autosomal dominant polycystic kidney disease. AJNR Am J Neuroradiol 2013; 34: 1556-1559.
54. Gieteling EW, Rinkel GJE. Characteristics of intracranial aneurysms and subarachnoid haemorrhage in patients with polycystic kidney disease. J Neurol 2003; 250: 418-422.
55. Schaaf I, Brilstra EH, Rinkel GJE et al. Quality of Life, Anxiety, and Depression in Patients With an Untreated Intracranial Aneurysm or Arteriovenous Malformation. Stroke 2002; 33(2): 440-443.
56. Solheim O, Eloqayli H, Muller TB et al. Quality of life after treatment for incidental, unruptured intracranial aneurysms. Acta Neurochir (Wien) 2006; 148(8): 821-830.
57. Joshwa B, Khakha DC, Mahajan S. Fatigue and depression and sleep problems among hemodialysis patients in a tertiary care center. Saudi J Kidney Dis Transpl 2012; 23: 729-735.
58. Koyama H, Fukuda S, Shoji T et al. Fatigue is a predictor for cardiovascular outcomes in patients undergoing hemodialysis. Clin J Am Soc Nephrol 2010; 5: 659-666.
2. Kimmel PL, Thamer M, Richard CM, Ray NF. Psychiatric illness in patients with end-stage renal disease. Am J Med 1998; 105(3): 214-221.
3. Cukor D, Coplan J, Brown C et al. Depression and anxiety in urban hemodialysis patients. Clin J Am Soc Nephrol 2007; 2: 484-490.
4. Pérez Domínguez TS, Buset Rios N, Rodriguez Esparragon F et al. Psychonephrology: Psychological aspects in autosomal dominant polycistic kidney disease. Nefrologia 2011; 31(6): 716-722.
5. Finkelstein FO, Finkelstein SH. Depression in chronic dialysis patients: assessment and treatment. Nephrol Dial Transplant 2000; 15: 1911-1913.
6. Waraich P, Goldner EM, Somers JM et al. Prevalence and incidence studies of mood disorders: a systematic review of the literature. Can J Psychiatry 2004; 49: 124-138.
7. Cohen SD, Norris L, Acquaviva K et al. Screening, diagnosis, and treatment of depression in patients with end-stage renal disease. Clin J Am Soc Nephrol 2007; 2: 1332-1342.
8. Katon WJ. Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues Clin Neurosci 2011; 13: 7-23.
9. Joynt KE, Whellan DJ, O’Connor CM. Depression and cardiovascular disease: mechanisms of interaction. Biol Psychiatry 2003; 54: 248-261.
10. Frasure-Smith N, Lespérance F, Habra M et al. Atrial Fibrillation and Congestive Heart Failure Investigators. Elevated depression symptoms predict long-term cardiovascular mortality in patients with atrial fibrillation and heart failure. Circulation 2009; 20: 134-140.
11. Burton HJ, Kline SA, Lindsay RM et al. The relationship of depression to survival in chronic renal failure. Psychosom Med 1986; 48: 261-269.
12. Arapaslan B, Soykan A, Soykan C et al. Cross-sectional assessment of psychiatric disorders in renal transplantation patients in Turkey: a preliminary study. Transplantation Proceedings 2004; 36: 1419-1421.
13. Saglimbene V, Palmer S, Scardapane M et al. Depression and allcause and cardiovascular mortality in patients on haemodialysis: a multinational cohort study. Nephrol Dial Transplant 2017; 32(2): 377-384.
14. Hedayati SS, Bosworth HB, Briley LP et al. Death or hospitalization of patients on chronic hemodialysis is associated with a physician-based diagnosis of depression. Kidney Int 2008; 74: 930-936.
15. Palmer S, Vecchio M, Craig JC et al. Prevalence of depression in chronic kidney disease: systematic review and meta-analysis of observational studies. Kidney Int 2013; 84: 179-191.
16. Abdel-Kader K, Unruh ML, Weisbord SD. Symptom burden, depression, and quality of life in chronic and end-stage kidney disease. Clin J Am Soc Nephrol 2010; 5(9): 1566-1573.
17. Panagopoulou A, Hardalias A, Berati S, Fourtounas C. Psycho-social issues and quality of life in patients on renal replacement therapy. Saudi J Kidney Dis Transpl 2009; 20: 212-218.
18. Masoumi M, Naini AE, Aghaghazvini R et al. Sleep quality in patients on maintenance hemodialysis and peritoneal dialysis. Int J Prev Med 2013; 4: 165-172.
19. Griffin KW, Wadhwa NK, Friend R, Suh H, Howell N, Cabralda T et al. Comparison of quality of life in hemodialysis and peritoneal dialysis patients. Adv Perit Dial 1994; 10: 104-108.
20. Watnick S, Kirwin P, Mahnensmith R, Concato J. The prevalence and treatment of depression among patients starting dialysis. Am J Kidney Dis 2003; 41(1): 105-110.
21. Smith MD, Hong BA, Robson AM: Diagnosis of depression in patients with end-stage renal disease. Comparative analysis. Am J Med. 1985; 79: 160-166.
22. Grant D, Almond MK, Newnham A et al. The Beck Depression Inventory requires modification in scoring before use in a haemodialysis population in the UK. Nephron Clin Pract 2008; 110: 33-38.
23. Theofilou PA. Sexual functioning in chronic kidney disease: the association with depression and anxiety. Hemodial Int 2012; 16(1): 76-81.
24. Song MK, Ward SE, Hladik GA et al. Depressive symptom severity, contributing factors, and self-management among chronic dialysis patients. Hemodial Int 2016; 20: 286-292.
25. Di Lullo L, Rivera R, Barbera V et al. Sudden cardiac death and chronic kidney disease: from pathophysiology to treatment strategies. Int J Cardiol 2016; 217: 16-27.
26. Cukor D, Rosenthal DS, Jindal RM et al. Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients. Kidney Int 2009; 75: 1223-1229.
27. Koo JR, Yoon JW, Kim SG et al. Association of depression with malnutrition in chronic hemodialysis patients. Am J Kidney Dis 2003; 41: 1037-1042.
28. Kimmel PL, Peterson RA. Depression in end stage renal disease patients: Tools, correlates, outcomes and needs. Semin Dial 2005; 18: 91-97.
29. Kimmel PL, Peterson RA, Weihs KL et al. Multiple measurements of depression predict mortality in a longitudinal study of chronic hemodialysis outpatients. Kidney Int 2000; 57: 2093-2098.
30. Kurella M, Kimmel PL, Young BS et al. Suicide in the United States end-stage renal disease program. J Am Soc Nephrol 2005; 16: 774-781.
31. Walters BA, Hays RD, Spritzer KL et al. Health-related quality of life, depressive symptoms, anemia, and malnutrition at hemodialysis initiation. Am J Kidney Dis 2002; 40: 1185-1194.
32. Rizk D, Jurkovitz C, Veledar E et al. Quality of life in autosomal dominant polycystic kidney disease patients not yet on dialysis. Clin J Am Soc Nephrol 2009; 43: 560-566.
33. Miskulin DC, Abebe KZ, Chapman AB et al. Health-related quality of life in patients with autosomal dominant polycystic kidney disease and CKD stages 1-4: a cross-sectional study. Am J Kidney Dis 2014; 63: 214-226.
34. Suwabe T, Ubara Y, Mise K et al. Quality of life of patients with ADPKD-Toranomon PKD QOL study: cross-sectional study. BMC Nephrol 2013; 14: 179.
35. Simms RJ, Thong KM, Dworschak GC et al. Increased psychosocial risk, depression and reduced quality of life living with autosomal dominant polycystic kidney disease. Nephrology Dialysis Transplantation 2016; 31(7): 1130-1140.
36. Nagler EV, Webster AC, Vanholder R et al. Antidepressants for depression in stage 3-5 chronic kidney disease: a systematic review of pharmacokinetics, efficacy and safety with recommendations by European Renal Best Practice (ERBP). Nephrol Dial Transplant 2012; 27(10): 3736-3745.
37. Care A, DiMartini C, Crone M et al. Psychiatric aspects of organ transplantation in critical care. Crit Care Clin 2008; 24(4): 949-981.
38. Fischer MJ, Xie D, Jordan N et al. Factors associated with depressive symptoms and use of antidepressant medications among participants in the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC Studies. Am J Kidney Dis 2012; 60: 27-38.
39. Lopes AA, Albert JM, Young EW et al. Screening for depression in hemodialysis patients: associations with diagnosis, treatment, and outcomes in the DOPPS. Kidney Int 2004; 66: 2047-2053.
40. Nagler EV, Webster AC, Vanholder R et al. Antidepressants for depression in stage 3-5 chronic kidney disease: a systematic review of pharmacokinetics, efficacy and safety with recommendations by European Renal Best Practice (ERBP). Nephrol Dial Transplant 2012; 27: 3736-3745.
41. Eyler RF, Unruh ML, Quinn DK et al. Psychotherapeutic agents in end-stage renal disease. Semin Dial 2015; 28: 417-426.
42. Cohen LM, Levy NB, Tessier EG et al. W: Levenson JL (red). The American Psychiatric Publishing textbook of psychosomatic medicine. 1st ed. Washington: American Psychiatric Publishing 2005: 483-490.
43. Cukor D, Coplan J, Brown C et al. Course of depression and anxiety diagnosis in patients treated with hemodialysis: a 16-month follow-up. Clin J Am Soc Nephrol 2008; 3: 1752-1758.
44. Moreira JM, da Matta SM, Melo e Kummer A et al. Neuropsychiatric disorders and renal diseases: an update. J Bras Nefrol 2014; 36(3): 396-400.
45. Bandelow B, Sher L, Bunevicius R et al. WFSBP Task Force on Mental Disorders in Primary Care; WFSBP Task Force on Anxiety Disorders, OCD and PTSD. Guidelines for the pharmacological treatment of anxiety disorders, obsessive-compulsive disorder and posttraumatic stress disorder in primary care. Int J Psychiatry Clin Pract 2012; 16: 77-84.
46. Morrison G, Chiang ST, Kopke HH et al. Effect of Renal Imparement on Hemodialysis on lorazepam kinetics. Clin Pharmacol Ther 1984; 35(5): 646-652.
47. Kulesza A, Niemczyk M, Gradzik M. Intracranial Manifestations of Autosomal Dominant Polycystic Kidney Disease. Int J Neurol Res 2016; 2(1): 210-215.
48. Pirson Y, Chauveau D, Torres V. Management of cerebral aneurysms in autosomal dominant polycystic kidney disease. J Am Soc Nephrol 2002; 13(1): 269-277.
49. Thompson BG, Brown RD Jr, Amin-Hanjani S et al. Guidelines for the Management of Patients With Unruptured Intracranial Aneurysms: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2015; 46(8): 2368-2400.
50. Menghini VV, Brown RD Jr, Sicks JD et al. Incidence and prevalence of intracranial aneurysms and hemorrhage in Omsted County, Minnesota 1965 to 1995. Neurology 1998; 51: 405-411.
51. Rinkel GJE. Intracranial aneurysm screening: indications and advice for practice. Lancet Neurology 2005; 4: 122-128.
52. Pirson Y. Extrarenal manifestations of autosomal dominant polycystic kidney disease. Adv Chronic Kidney Dis 2010; 17: 173-180.
53. Niemczyk M, Gradzik M, Niemczyk S et al. Intracranial aneurysms in autosomal dominant polycystic kidney disease. AJNR Am J Neuroradiol 2013; 34: 1556-1559.
54. Gieteling EW, Rinkel GJE. Characteristics of intracranial aneurysms and subarachnoid haemorrhage in patients with polycystic kidney disease. J Neurol 2003; 250: 418-422.
55. Schaaf I, Brilstra EH, Rinkel GJE et al. Quality of Life, Anxiety, and Depression in Patients With an Untreated Intracranial Aneurysm or Arteriovenous Malformation. Stroke 2002; 33(2): 440-443.
56. Solheim O, Eloqayli H, Muller TB et al. Quality of life after treatment for incidental, unruptured intracranial aneurysms. Acta Neurochir (Wien) 2006; 148(8): 821-830.
57. Joshwa B, Khakha DC, Mahajan S. Fatigue and depression and sleep problems among hemodialysis patients in a tertiary care center. Saudi J Kidney Dis Transpl 2012; 23: 729-735.
58. Koyama H, Fukuda S, Shoji T et al. Fatigue is a predictor for cardiovascular outcomes in patients undergoing hemodialysis. Clin J Am Soc Nephrol 2010; 5: 659-666.