Managing Stress: What Kidney Patients, Family Members, and Caregivers Need to Know

By Ramiro Valdez, PhD

Managing Stress

Most people go their entire lives without giving their kidneys any thought. Relatively few people even know what kidneys do. It is only when they stop working that people realize just how important are these small internal organs.

Emotional Stress
Trying to replace what kidneys used to do requires hemodialysis treatments three times a week, or daily exchanges for the peritoneal dialysis patient, or a renal transplant. But dialysis is just the beginning. There are daily medicines, dietary restrictions, fluid limitations, and financial burdens that accompany dialysis treatments. This can result in extreme emotional stress.

Emotional stress, although common, can become overwhelming if not resolved correctly. The usual symptoms include:

  • Restlessness;
  • Changes in sleeping habits (either loss of, or too much, sleep);
  • Changes in eating habits (loss of appetite or overeating of the wrong foods);
  • Irritability;
  • Headaches;
  • Stomach problems;
  • Inability to cope with common every day events; and
  • Muscular aches and pains, especially along the shoulders and back.


Amount of Stress
The amount of stress will vary from one kidney patient to another. Some have very few medical complications, and their dialysis experience restricts them only a little. These patients will have little stress associated with their illness. They may experience some headaches or tightening of the muscles along the neck and shoulder, but little more.

Others have many medical complications besides kidney failure, or find themselves isolated, uninformed, and lonely. These patients may find it hard to cope with daily concerns. This can lead to extreme stress and, perhaps, even more medical complications. Along with the headaches and neck/shoulder aches, these people may have trouble sleeping, loss of appetite, and stomach problems such as frequent diarrhea. Extreme cases of stress can lead to such problems as spastic colitis, irritable bowel syndrome, and weakened immunological systems.

Learning to Cope
The reality is that stress can worsen almost any illness, including kidney failure, and learning to cope with stress can make an illness more tolerable. There are several very effective ways to cope with stress, and patients may choose whichever method works best for them.

The following recommendations have been found helpful for other people with kidney failure. None will work for everyone, but one or two should work for almost any patient with kidney failure.

Many people have found the simple exercises of Yoga helpful. Others choose to meditate with a relaxing walk along a river or through a forest. Some patients combine prayer with meditation if this fits into their lifestyle.

Meditation involves mentally “getting away” from the fuss and bother of the daily rush for a few minutes of calm and rejuvenation. This can be done simply by sitting still for 10 or 15 minutes and cleansing the mind of all thoughts. As simple as this sounds, it can be very helpful in relieving stress.

Nearly any patient with renal failure can do some form of exercise, as approved by their doctor. For some patients, this involves 20 minutes of jogging, bike riding, or even aerobic workouts. For others with less stamina, this can mean simply walking around the kitchen table three or four times.

Any exercise allowed by the doctor will be helpful. The general rule of thumb is 20-30 minutes three times a week, whether it’s jogging or simply walking slowly around the block. Exercise is indeed an excellent way to relieve stress.

For those who can afford it, hiring a masseuse can work wonders to relieve stress. Those patients who are not able to hire someone can participate in simple back rubbing with a spouse or family member.

Massage can relax tightened muscles and soften them once again, whether it’s done professionally or by a family member. Relaxing the muscles will, in turn, go a long way towards coping better with stress.

Talking to Someone
Talking to someone about your problems is a tried and true method of stress relief. It is not necessary to hire a professional, although this is also helpful, but simply talking to a family member or friend helps.

Renal social workers are highly trained professionals who know how to listen, and wise patients will take advantage of this. Some people can talk to a pastor, rabbi, or priest, and this is also very helpful. It is important to talk to someone who will listen without wanting to unload his/her own problems in turn, but who will be supportive and simply hear you out. It is not necessary to seek or give advice, but simply talk things out with someone. The power of a receptive ear is remarkable for stress relief.

There are excellent medicines on the market to help relieve stress. These can be recommended or even prescribed by a nephrologist. This can be done by simply talking to the doctor about stress and asking for a prescription to help.

Patients who are already taking numerous medicines a day may hesitate to take yet one more pill, but once they find the effects are helpful, they will be glad they are doing it. Kidney patients should avoid over-the-counter stress-relief medications unless their doctor recommends it.

Support Groups
Many dialysis clinics and transplant centers have support groups where patients can attend and talk to other patients about things that cause stress to them. This is an excellent way to relieve stress.

The supportive atmosphere of fellow patients can work wonders in helping people learn how to take better care of themselves. Fellow group members may also know of ways to cope with stress. Some people may not be comfortable talking about their problems in a group setting. They will do better to talk one-on-one to the clinic social worker or another staff member.

Patient Education
When it comes to taking care of oneself, there is no such thing as too much information. Finding the ways that dialysis, in its several forms, affects the body and mind is always helpful. Learning ways to enhance dialysis through taking good care of oneself is an act of self-empowerment. This, in turn, will give patients a greater sense of control over their lives.

Taking control over one’s life is an excellent way to reduce stress. Listening to the doctor’s advice and heeding the recommendations of the healthcare team is the beginning of a good education.

Individual Resolve 
A quote attributed to Abraham Lincoln goes something like this: “Most folks are as happy as they make up their minds to be.” While it seems simplistic, making up one’s mind to see the glass as half full instead of half empty is very helpful and within everyone’s reach.

Dialysis can be seen as a curse or a blessing that keeps one alive. Each patient has to decide for him- or herself which it will be.

There are other ways patients can cope with stress and improve their quality of life. Talking to their doctor or social worker is the first step in finding these ways. The important thing is that patients recognize that stress is common, that it can have some negative effects on their health, and that coping with stress successfully is always a healthy thing to do.

There is a Chinese proverb that says: “A journey of a thousand miles begins with one step.” Taking that first step toward recognizing stress and deciding to deal with it is where stress relief begins.

How to Deal with Difficult Staff - Managing Stress:About the Author
Ramiro Valdez, PhD, is a Psychosocial Services Consultant who runs Valdez Seminars in Dallas, TX. Previously, he was Director of Patient Services for the End-Stage Renal Disease (ESRD) Network of Texas. He has nearly 25 years experience in the end-stage renal disease field and is the author of over 30 articles in renal journals and magazines. For more information, log onto:

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