JMIR Publications

ABSTRACT

Background:

Chronic kidney disease (CKD) affects more than 850 million people worldwide, yet the emotional and psychosocial burdens remain underrecognized in nephrology practice. This review explores the overlooked dimensions of loneliness, uncertainty, and emotional suffering in CKD, drawing attention to their implications for both patients and caregivers.

Objective:

The objective of the current review article is to elucidate the mechanisms of the distresses experienced by the hemodialysis patients and their carers

Methods:

We conducted a narrative synthesis of qualitative and quantitative studies across pediatric, adult, and elderly populations, with additional perspectives from culturally and linguistically diverse groups and caregivers

Results:

Loneliness and social isolation affect more than 40% of dialysis patients and are consistently linked with depression, reduced adherence, hospitalization, and increased mortality. Uncertainty about disease trajectory and treatment outcomes generates chronic psychological strain, particularly in older adults. Caregivers report high emotional burden, social withdrawal, and diminished well-being. Despite growing recognition of these issues, systematic psychosocial screening and targeted interventions remain rare in routine nephrology.

Conclusions:

This review highlights loneliness and uncertainty as silent but modifiable risk factors in CKD, on par with traditional biomedical markers. We argue that nephrology urgently requires a shift toward a biopsychosocial model of care that includes structured emotional screening, culturally responsive interventions, and caregiver support. By reframing psychosocial suffering as a clinical priority rather than a secondary concern, nephrology can move toward more person-centered and equitable care.