Depression in chronic kidney disease and dialysis: A psychonephrology narrative review

doi:10.5527/wjn.121696

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World Journal of Nephrology

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2220-6124

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Nephrol. Sep 25, 2026; 15(3): 121696
Published online Sep 25, 2026. doi: 10.5527/wjn.121696

Table 4 Chronic kidney disease related factors contributing to resistance to antidepressants

CKD related factors	Mechanism
Chronic inflammation, cytokines, uremic toxins[65]	↓ Serotonin/dopamine signaling IL-6/TNF-α blunt SSRI response
Vascular disease/endothelial dysfunction[66]	White matter hyperintensities
Blood-brain barrier impairment[46]	Uremic toxins disrupt BBB permeability, ↓CNS drug delivery
Pharmacokinetic alterations[67]	↓ Renal clearance (50%-70%), altered protein binding, drug accumulation
High pill burden/poor adherence[68]	Drug - drug interactions

CKD: Chronic kidney disease; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; SSRI: Selective serotonin reuptake inhibitors; BBB: Blood-brain barrier; CNS: Central nervous system.

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Citation: Yadav M, Kumar A, Pandey A, Singh S, Kumar R, Verma H, Mahajan S, Sharma S, Prasad P, Agarwal A. Depression in chronic kidney disease and dialysis: A psychonephrology narrative review. World J Nephrol 2026; 15(3): 121696
URL: https://www.wjgnet.com/2220-6124/full/v15/i3/121696.htm
DOI: https://dx.doi.org/10.5527/wjn.121696

Yadav M, Kumar A, Pandey A, Singh S, Kumar R, Verma H, Mahajan S, Sharma S, Prasad P, Agarwal A. Depression in chronic kidney disease and dialysis: A psychonephrology narrative review. World J Nephrol 2026; 15(3): 121696 [PMID: 42626288 DOI: 10.5527/wjn.121696]

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