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A patient’s journey on dialysis can be difficult not just physically but mentally and emotionally as well. In fact, 40% of patients receiving dialysis report feeling depressed while 42% report feeling anxious at some or all points during dialysis. And this number might even be higher. Mental health symptoms among dialysis patient are widely underdiagnosed as well as undertreated.

There is a clear need to increase supports for patients on dialysis, but to do that effectively clinical teams must also have the tools and supports to both identify and manage mental health symptoms.

This is what Dr. Kara Schick-Makaroff and her team out of the University of Alberta sought to provide in their recent publication "Developing and Tailoring a Person-Centred Pathway for Mental Health Care for People Receiving Dialysis”.

In the research paper, the research team outlined their unique method in developing a pathway – a clinical tool – to help guide clinicians better engage with patients about their mental health and better manage patient’s mental health.

That study arose from previous work they were doing to evaluate quality of life among dialysis patients. During that study, it was noted, quite starkly, that patients felt that clinicians were not equipped to have conversations around mental health nor treat it.

To develop this tool, the research team first worked to identify the current processes, health services, and interventions that existed for dialysis patients in Alberta. To inform the pathway’s development, they engaged with not only clinicians, but also a diverse range of persons with lived experience and other important stakeholders.

Evaluating the current body of practice alongside clinical expertise and lived experience expertise, they were they able to development a resource that was patient-focused and dimensional.

The resulting tool provides clinicians with an algorithm that helps guide them in preforming: initial conversations, assessments, follow ups, and management (with or without medications).

While the tool created from this work is unique to Alberta, the developmental approach taken by the research team can be transferred to other kidney care programs – meaning a greater impact for on mental health care for dialysis patients nationally and internationally.

Overall, this tool – and others like it – will help to open a dialogue between healthcare providers and their patients, assisting clinicians in identifying when a patient needs additional mental health supports.

Providing dialysis patients the care and support they need in all aspects of their health is a key step in achieving an overall better quality of life.

Read the research article here: https://karger.com/nef/article/doi/10.1159/000544058/921663/Developing-and-tailoring-a-person-centred-pathway (English only)

You can also check out more work from this research team, including mental health supports and tools tailored to patients with kidney disease here: https://www.healthyqol.com/kidney (English only)

Full article citation: Schick-Makaroff et al. Developing and Tailoring a Person-Centred Pathway for Mental Health Care for People Receiving Dialysis. Nephron, 2025. https://doi.org/10.1159/000544058

This research was funded in part by The Kidney Foundation of Canada.