Psychological support could improve care for people with kidney disease, new study shows

man lying down on yoga mat watching laptop

Researchers found self-confidence training and exercise programmes can help people feel more in control, boost mood and improve physical function. 

The new NIHR-funded study led by researchers at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, has shown that people living with chronic kidney disease could benefit from earlier access to psychological and behavioural support.

Chronic kidney disease affects 10 to 15 percent of adults worldwide and represents a global public health priority according to the World Health Assembly. Many people also experience depression or anxiety, which can worsen health outcomes and increase the risk of hospitalisation and premature death. However, psychological support often only reaches patients once their kidneys are failing.

The systematic review, published in The Journal of Nephrology, is the first to examine whether psychological and behavioural interventions help adults with chronic kidney disease before they require dialysis or a kidney transplant.

The findings, drawn from five international clinical trials from the UK (two trials), USA, China and Taiwan in 2017 to 2024, involving over 600 participants, demonstrate that cognitive behavioural therapy, mindfulness, structured exercise programmes and ‘self-efficacy training’ which builds patients’ beliefs in their ability to perform tasks and reach their goals, consistently improve their patient’s mood, self-confidence, physical functioning and their ability to manage their health. These approaches were effective when delivered digitally, by telephone or in-person.

The effects on anxiety, quality of life and kidney function were less clear, highlighting the need for larger and longer-term studies.

Pooja Schmill, NIHR Maudsley BRC Doctoral Student at the IoPPN and lead author of the study, said:

"Too often, psychological support only reaches people once they have kidney failure. Our research shows the benefits of bringing this support earlier, helping people feel more in control, stay physically active, and potentially reduce the impact of chronic kidney disease on daily life."

Professor Joseph Chilcot, Professor of Health Psychology at the IoPPN, Deputy Head of the Department of Psychology, and senior author of the study

"This is a crucial step toward embedding whole-person care in kidney services, which is currently lacking in the UK. Integrating psychological support alongside medical treatment could transform outcomes for patients and reduce pressures on the NHS."

Building on these findings, the researchers are now developing iADJUST, a digital psychological intervention designed to support people earlier in the chronic kidney disease pathway. The project team includes health psychologists, renal clinicians, digital health experts and patient partners, working together to improve whole-person care in kidney disease.

The study was funded by the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre.

 

“Do psycho-behavioural interventions improve mental and physical health in chronic kidney disease? A systematic review of randomised controlled trials” was published in The Journal of Nephrology. DOI: 10.1007/s40620-025-02372-9


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By NIHR Maudsley BRC at 12 Sep 2025, 14:45 PM


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