Psychonephrology: psychological aspects in autosomal dominant polycystic kidney disease.

The biological, physical and psychological burden of a chronic disease has an impact on the quality of life of people who suffer from it. The perception of quality of life is affected by psychological disorders such as anxiety and depression that have a high prevalence in people with chronic kidney disease (CKD). These factors are also linked to lower life expectancy. It is therefore surprising that the psychological aspects of people with autosomal dominant polycystic kidney disease (ADPKD) have received so little attention in the medical literature, despite their importance for the overall health of these patients. The relatively new discipline called psychonephrology provides a broader view of the impact that these aspects have on individuals with chronic kidney disease, with a consequent practical application. In this article, we examine the consequences and prevalence of psychological problems that can be related to CKD and ADPKD. Firstly, we will focus on the field of CKD and ADPKD within the scope of psychonephrology. Secondly, the article introduces the concept of quality of life as a basic pillar of health that is affected when a person is diagnosed with CKD. Thirdly, we will present a summary of the main research related to anxiety and depression disorders in CKD and ADPKD. The article will conclude by synthesising findings from the different lines of research undertaken.

[Simultaneous, bilateral and permanent ventilation with a diaphragm pacing in childhood: the implantation technique and indications]. / Ventilación permanente, bilateral y simultánea con marcapasos diafragmático en la infancia: Indicaciones y técnica de implante.

The acute effects of external stimulation were well demonstrated by the turn of the century, but the chronic application had to wait until the advent of the modern pacemaker technology. Since 1983 we have implanted bilateral diaphragm pacing in ten infants and adolescents with quadriplegia and central hypoventilation syndrome. The preferred site of implantation was the thoracic phrenic nerve. The electrophysiological status of the phrenic nerve function has before been determined in all patients. We have got bilateral and continuous ventilation, in all patients, but, in quadriplegics is necessary a conditioning period. Long term stimulation of the phrenic nerves to pace the diaphragm is an effective method of ventilatory support in selected cases.