Psychopharmacotherapy of affective disorders in patients with chronic kidney disease receiving therapy with programmed hemodialysis

Affective disorders such as depression and anxiety occur in a significant proportion of patients with chronic kidney disease, especially those who receive programmed hemodialysis therapy. According to epidemiological studies, depression is detected from 20 to 40% in patients on hemodialysis, and the level of anxiety disorders reaches from 25 to 50%. Treatment of affective disorders in patients with chronic kidney disease is complicated by changes in the pharmacokinetics and pharmacodynamics of drugs. In patients receiving hemodialysis treatment, the glomerular filtration rate is reduced, which affects the excretion of drugs and requires dosage adjustments, especially when using antidepressants and anxiolytics. In this regard, the issue of choosing safe and effective psychopharmacotherapy regimens remains extremely relevant in the treatment of depressive and anxiety disorders in patients with chronic kidney disease. The purpose of the review: to analyze the effectiveness and safety of psychopharmacotherapy of affective disorders in patients with chronic kidney disease receiving programmed hemodialysis therapy, as well as to provide modern treatment regimens taking into account the specifics of metabolism and drug excretion in this category of patients.