Depressive symptoms in chronic kidney disease: the hidden role of uremic toxins

To evaluate the association between uremic toxins (UTs) and depressive symptoms in a cohort of non-dialysed adults with chronic kidney disease (CKD).

Cohort Study: The study utilized the CKD-REIN cohort comprising 3033 CKD stage 2–5 patients with 5 years of follow-up, assessing changes in depressive symptoms using the CESD scale.
Statistical Analysis: Mixed models were employed to examine associations between changes in CESD scores and baseline levels of various UTs.

2165 patients were included with a median age of 68 years and mean eGFR of 35 mL/min/1.73 m²; median baseline CESD score was 7 and mean follow-up time was 4.0 years.
The CESD score increased by 0.11 points per year after adjusting for confounders.
Doubling PAG levels was associated with an additional increase of 0.06 points per year in CESD.
Doubling IS and IAA levels was linked to higher mean CESD scores but not to score changes over time.

PAG was significantly associated with changes in CESD score over time, while higher IS and IAA levels correlated with higher mean scores.

The study did not include patients on kidney replacement therapy.
Further studies are needed to confirm the findings and explore the potential for therapeutic strategies targeting UTs.

Further studies are needed to confirm the findings and explore the potential for therapeutic strategies targeting UTs.