Depression Therapies Fail Trial for Kidney Patients
New study finds neither behavioral activation therapy nor bupropion improves depression in chronic kidney disease patients.
Updated on Oct. 28, 2026 in Mental Health
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Would you prefer behavioral therapy over medication to manage depression if you had chronic kidney disease?
The CONCORD trial has determined that neither behavioral activation therapy nor the antidepressant bupropion provides superior relief for depression in patients with chronic kidney disease. While behavioral activation therapy showed initial promise at eight weeks, those benefits did not persist by the end of the 16-week study period.
Why it matters
Researchers launched the study to identify viable depression treatments after previous evidence indicated sertraline caused adverse gastrointestinal effects in patients with advanced kidney disease. Finding effective mental health interventions remains a priority given that roughly 1 in 5 patients with chronic kidney disease also live with depression.
In the trial of 202 patients, bupropion was associated with a 13 percent rate of insomnia and a 7 percent rate of confusion. Researchers compared these outcomes against a control group to evaluate therapy efficacy across kidney disease stages G3b to G5D.
The players
CONCORD Trial
This randomized clinical trial investigated the efficacy of behavioral activation therapy and bupropion for patients with stage G3b to G5D chronic kidney disease.
ASN Kidney Week 2026
This annual medical conference serves as a global gathering for nephrology professionals to discuss the latest advancements and clinical findings in kidney research.
The details
The trial randomized participants to receive either behavioral activation therapy, bupropion at a 150 mg daily dose, or a control intervention. To ensure consistency, clinicians delivered behavioral activation sessions via video to match the contact time provided to other study arms.
Timeline
A 2013 systematic review identified that 1 in 5 chronic kidney disease patients suffer from depression.
The 2017 CAST trial previously found no significant benefit for sertraline usage.
The study results were presented at ASN Kidney Week 2026 in Denver between October 21-25, 2026.
Behavioral activation therapy showed greater symptom improvement than the control group at week 8.
No treatment strategy proved superior to the control group by the end of the 16-week trial.
Health Landscape
This study follows the precedent set by the 2017 CAST trial, which similarly failed to find a significant benefit for sertraline treatments in patients with chronic kidney disease. These results underscore the ongoing challenge of managing mental health within the complex physiological constraints of advanced kidney disease.
Patients with chronic kidney disease should consult their nephrologist regarding the potential side effects of antidepressant medications, such as the insomnia and confusion noted with bupropion. This study highlights the need for continued clinical discussion about how to safely and effectively manage depression symptoms when standard options remain unproven for this population.
The takeaway
These findings suggest that established depression treatments may not provide the same benefits to patients with chronic kidney disease as they do in the general population. Physicians and patients are encouraged to monitor for adverse effects and continue exploring alternative management pathways for mental health.
Further reading
For additional context on research in this field, visit the Mental Health section.
Live Poll
Would you prefer behavioral therapy over medication to manage depression if you had chronic kidney disease?
