Blog Post

Addressing Behavioral Health in CKD and ESRD Patients


Coping with the Emotional Impact of Kidney Disease: Navigating Loneliness, Depression, and the Transition to ESRD


Receiving a diagnosis of chronic kidney disease (CKD) can be a life-altering experience, triggering a range of emotions and behavioral health challenges. Coping with the emotional impact of this diagnosis is a journey that affects not only patients but also their families and loved ones. In this article, we will:

  • Explore some common behavioral health issues faced by individuals with kidney disease.
  • Focus on the transition from CKD to end-stage renal disease (ESRD) and the resulting increased risk of depression.
  • Discuss the significance of social isolation as a Social Determinant of Health (SDoH) and its implications on emotional well-being.
  • Offer tips to help patients and their loved ones manage behavioral health challenges during this difficult time.

At Healthmap Solutions (Healthmap), we understand that addressing behavioral health concerns is critical to improving health outcomes for patients with CKD and ESRD. As part of our Kidney Population Health Management program, all participating patients receive a behavioral health screening and can be referred to one of the behavioral health professionals on our Care Navigation team for support, if needed. We believe it is important for patients and their loved ones to understand that behavioral health plays an extremely important role throughout the kidney disease journey, and experiencing behavioral health issues is normal. Furthermore, there are several actions that patients can take to help manage and alleviate their behavioral health challenges, and Healthmap is here to help.

Loneliness and Depression when Diagnosed with Kidney Disease

The emotional impact of a kidney disease diagnosis can be overwhelming, and feelings of loneliness and depression are common for these patients. The sense of isolation may arise from the uncertainty and fear of the future, as well as the challenges of managing a chronic illness. Patients may struggle to find understanding and support from friends and family who may not fully grasp the complexities of kidney disease.

Depending on the severity of the condition, kidney disease can impact a patient's social life and ability to engage in activities they once enjoyed. The need for more medical appointments, dietary restrictions, and limitations on physical abilities can lead to increased feelings of loneliness and social withdrawal. Working with a trusted behavioral health professional or counselor can be immensely beneficial for patients who are struggling to cope with their new lifestyle changes and feelings of loneliness.

Transitioning to ESRD and the Heightened Risk of Depression

Depression is particularly common in patients with ESRD. Studies have shown that the rate of depression in patients with ESRD is five times higher than that of the general population.1 As kidney disease progresses from CKD to ESRD, patients face a significant increase in the risk of depression. The transition to ESRD is a critical and challenging phase, marked by a substantial decline in kidney function, necessitating dialysis or a kidney transplant to sustain life.

The process of adjusting to life with ESRD can be emotionally draining. Patients may experience a sense of loss and grief as they navigate the changes in their daily routines, employment status, and social interactions. Moreover, the physical and financial burdens associated with ESRD can add stress and anxiety, further exacerbating the risk of depression.

Social Isolation as a Social Determinant of Health (SDoH)

In recent years, social isolation and loneliness have been recognized as a significant SDoH that impact overall well-being, especially for older individuals.2 When individuals lack social connections and a support system, their behavioral health can suffer significantly.

In the context of kidney disease, social isolation can occur due to limited mobility, time-consuming treatments, and the need for rest and recovery. The sense of being cut-off from their social circles can lead to worsening loneliness and depression, making it crucial to address these factors as part of a comprehensive healthcare approach.

Tips for Patients to Manage Behavioral Health Issues

When diagnosed with kidney disease, coping with behavioral health issues requires a proactive, compassionate, and comprehensive strategy. Here are some essential tips from Healthmap that we use to help patients navigate emotional challenges:

  1. Educate Yourself: Knowledge about kidney disease and its management can empower patients to take control of their health and make informed decisions. Engage with healthcare providers, ask questions, and seek reliable information from reputable sources.
  2. Build a Support System: Cultivate a network of understanding and empathetic individuals who can offer emotional support. Join support groups, both in-person and online, where you can share experiences and find solace in knowing you’re not alone. Healthmap recommends the National Kidney Foundation’s program, NKF PEERS3, which connects kidney patients with trained mentors who have experienced dialysis, transplant, or living kidney donation.
  3. Communicate Openly: Don't hesitate to talk about your feelings and concerns with loved ones or behavioral health professionals. Honest communication can help others understand your needs and provide the necessary support.
  4. Prioritize Self-Care: Taking care of your mental and physical health is crucial. Engage in activities that bring joy and relaxation, practice mindfulness techniques, exercise, and ensure you get enough rest. Because alcohol can have negative health consequences, taking steps to reduce or stop alcohol intake can also improve mood and overall health.
  5. Seek Professional Help: If you find yourself struggling with persistent feelings of loneliness or depression, consider consulting a behavioral health professional. Therapy and counseling specialized in chronic illness can provide valuable tools and coping strategies.
  6. Stay Connected: Use technology to stay connected with family and friends, even if in-person interactions are limited. Virtual communication platforms can bridge the gap and maintain social ties.
  7. Engage in Hobbies: Pursue hobbies and activities that inspire you and provide a sense of accomplishment. Engaging in creative outlets or hobbies can be therapeutic and boost overall well-being.
  8. Monitor Progress: Keep track of your behavioral health and any changes in your emotions. Regularly evaluate how you are coping with the challenges and seek help if needed.


Coping with behavioral health issues when diagnosed with kidney disease requires resilience, support, and a commitment to self-care. Loneliness and depression are common emotions that many patients face, particularly during the transition from CKD to ESRD. Moreover, social isolation has emerged as a significant SDoH that can exacerbate these challenges.

At Healthmap, we know that by being proactive in managing behavioral health, seeking support, and implementing coping strategies, patients can navigate the emotional impact of kidney disease more effectively. The Healthmap team of experts takes a holistic approach to healthcare that acknowledges and addresses behavioral health alongside physical well-being as crucial in supporting patients on their journey to living well with kidney disease. Our Care Navigation team can help connect patients with a wide variety of resources in their own communities that can help alleviate some of the common risk factors associated with anxiety, depression, and other challenges related to kidney disease. Remember that reaching out for help is a sign of strength, and with the right support, managing behavioral health challenges will have a positive impact on overall physical well-being.


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