Depressive symptoms are common in patients with chronic kidney disease (CKD) but may be overlooked because fatigue, sleep disturbance, and appetite changes overlap with manifestations of kidney disease. Treatment remains challenging, and the limited evidence for antidepressant efficacy in CKD highlights the need to explore complementary therapeutic strategies. Emerging research suggests that interactions among the gut microbiota, kidney function, and brain may contribute to psychological symptoms.
Objective
To examine current evidence linking the gut–kidney–brain axis to depressive symptoms in CKD and explore the potential role of Jia Wei Xiao Yao San (JWXYS), a traditional Chinese herbal formula, as a candidate for future adjunctive treatment research.
MethodsThis narrative review integrates selected human observational studies, clinical trials, and experimental investigations concerning gut-derived metabolites, microbiota alterations, depressive symptoms, and integrative interventions. Attention is given to the clinical relevance and limitations of existing findings.