Monika Yadav, Adarsh Kumar, Rajesh Kumar, Himanshu Verma, Sanjiv Mahajan, Sourabh Sharma, Pallavi Prasad, Anupam Agarwal, Department of Nephrology, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi 110029, DL, India
Abhinav Pandey, Department of Psychiatry, T. S Mishra Medical College, Lucknow 226008, Uttar Pradesh, India
Swarndeep Singh, Department of Psychiatry, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, New Delhi 110029, India
Co-first authors: Monika Yadav and Adarsh Kumar.
Author contributions: Yadav M and Kumar A conceptualized the study and prepared the initial draft of the manuscript and they contributed equally to this manuscript as co-first authors; Pandey A, Singh S, and Kumar R contributed to literature review and data interpretation; Verma H, Mahajan S, Sharma S, and Prasad P critically revised the manuscript for important intellectual content; Agarwal A supervised the study and provided overall guidance. All authors contributed to manuscript revision, read, and approved the final version of the manuscript.
AI contribution statement: The authors used Grammarly for language editing, grammar correction, and improvement of manuscript readability during manuscript preparation and revision. No part of the scientific content, data collection, data analysis, or conclusions was generated by AI. No AI-generated images, figures, or graphical materials were included in the manuscript. All edits suggested by Grammarly were reviewed and approved by the authors, who take full responsibility for the accuracy, integrity, and originality of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Adarsh Kumar, DM, MD, Associate Professor, Department of Nephrology, Vardhman Mahavir Medical College (VMMC) and Safdarjung Hospital, Ansari Nagar West, Aurobindo Marg, Ring Road, New Delhi 110029, DL, India. adarshnephro081@gmail.com
Received: March 31, 2026 Revised: May 22, 2026 Accepted: June 22, 2026 Published online: September 25, 2026 Processing time: 136 Days and 1 Hours
Core Tip
Core Tip: Depression is one of the most common yet under-recognized comorbidities in chronic kidney disease (CKD), especially among patients receiving maintenance dialysis. Overlapping somatic symptoms of uremia often complicate its diagnosis, leading to under detection and undertreatment. Beyond its profound impact on quality of life, depression is associated with poor treatment adherence, increased hospitalization, malnutrition, reduced dialysis adequacy, and higher mortality. Emerging evidence suggests that inflammation, neuroendocrine dysregulation, uremic toxin accumulation, and psychosocial stressors collectively contribute to its pathogenesis. This review highlights the epidemiology, mechanisms, diagnostic challenges, and clinical consequences of depression across the CKD spectrum, while emphasizing the evolving role of psychonephrology in integrating psychological and renal care. Early recognition and multidisciplinary management are essential to improving holistic outcomes in CKD patients.
