Is Depression Dialyzable?

Depression is a common and debilitating comorbidity in patients with chronic kidney disease (CKD), particularly those with end-stage kidney disease (ESKD, CKD stage 5). This association stems from a complex interplay of biological and psychosocial factors, including the accumulation of uraemic toxins such as middle molecules, chronic inflammation, and the psychological burden of disease progression. Initiation of dialysis has been observed to alleviate depressive symptoms through multiple mechanisms: removal of uraemic toxins, improvement in physical health, and reduction in psychosocial stressors. This article reviews the pathophysiological underpinnings of depression in CKD, explores the impact of dialysis on depressive symptoms, and evaluates whether depression can be considered a "dialyzable" entity.