Gut-kidney-brain axis and daytime sleepiness in Parkinson's disease and chronic kidney disease: an expert narrative review
Abstract
Background: Excessive daytime sleepiness (EDS) is a debilitating comorbidity in over 80% of patients with Parkinson's disease (PD) and chronic kidney disease (CKD). Evidence implicates dysregulation of the gut-kidney-brain axis as a may contribute of EDS pathogenesis, though detailed mechanistic insights remain limited.
Objective: This review evaluates the efficacy of interventions targeting the gut-kidney-brain axis in ameliorating EDS among PD and CKD patients, benchmarking outcomes against standard care protocols.
Methods: We systematically queried PubMed, Cochrane Library, Embase, Web of Science, and Scopus for studies published between January 2000 and December 2025. Our search encompassed experimental, observational, and qualitative designs. Two reviewers independently conducted study selection and data extraction. Data synthesis incorporated random-effects models to address methodological heterogeneity.
Results: Analysis of 68 included studies (n = 15,392 participants) demonstrated that interventions such as specific probiotics significantly reduced Epworth Sleepiness Scale (ESS) scores by 8.2 points (95% CI: 7.1-9.3; I2 = 65%). Furthermore, biomarker-guided personalized strategies (BBPI) yielded a 3.2-fold higher improvement in EDS outcomes (OR = 3.2, 95% CI: 1.9-5.4).
Conclusions: Targeting the gut-kidney-brain axis holds substantial promise for managing EDS, supported by moderate-certainty evidence for BBPI-based approaches. However, clinical translation…
Read the paper
Related studies
- The Matrisome: In Silico Definition and In Vivo Characterization by Proteomics of Normal and Tumor Extracellular Matrices
- The Escherichia coli MG1655 in silico metabolic genotype: Its definition, characteristics, and capabilities
- In silico pharmacology for drug discovery: methods for virtual ligand screening and profiling
- In silico prediction of splice-altering single nucleotide variants in the human genome
- In silico clinical trials: how computer simulation will transform the biomedical industry
- In silico optimization of a guava antimicrobial peptide enables combinatorial exploration for peptide design
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.