Gut-kidney-brain axis and daytime sleepiness in Parkinson's disease and chronic kidney disease: an expert narrative review

Key Points

• Excessive daytime sleepiness management shows promise through targeting the gut-kidney-brain axis, emphasizing new therapeutic pathways.
• Moderate-certainty evidence supports BBPI-based approaches, which could transform patient care in Parkinson's and chronic kidney diseases.
• Observational analysis suggests that developing personalized intervention frameworks is crucial for effective treatment outcomes.
• Clinical translation requires validation through large-scale multicenter trials to confirm the suggested benefits and applications.