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These may include: Managing diabetes and high blood pressure Quitting smoking Maintaining a healthy weight Eating a balanced, low-sodium diet Staying physically active Your doctor may prescribe medications to help manage your kidney disease, such as: ACE inhibitors or ARBs to control blood pressure and reduce protein in urine Diuretics to help remove excess fluid Erythropoiesis-stimulating agents to treat anemia Phosphate binders to control phosphorus levels If your kidneys are no longer able to filter waste and excess fluid effectively, you may need dialysis

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Among the remaining subjects, we further excluded those who received a diagnosis of bipolar disorder during the follow-up assessment (n = 9), those with missing metabolite data due to the lack of blood samples (n = 158) and those who did not complete the Inventory for Depressive Symptoms questionnaire (n = 33)