<p>Depression is common among individuals with chronic kidney disease (CKD). The Common-Sense model suggests that illness representations are related to coping responses and emotional outcomes as individuals interpret and respond to health-related threats. This study investigated the associations between illness representations and depression in Chinese CKD patients, with a focus on maladaptive emotional coping and positive reframing as potential mediators. A total of 442 participants (mean age = 36.28, SD = 10.23; 57.5% female) with CKD were recruited. Participants completed self-reported measures assessing illness representations, coping strategies, and depression. Structural equation modeling was used to explore the relationships among illness representations, coping strategies, and depression. The study found that several dimensions of illness representations, including consequences, timeline acute/chronic, illness identity, illness concern, and emotional representations, were positively associated with depression. In contrast, personal control and treatment control were negatively associated with depression. In addition, maladaptive emotional coping and positive reframing showed significant indirect associations between illness representations and depression. Overall, the findings provide theory-informed evidence that illness representations, coping-related processes, and depression are closely associated in patients with CKD. These results may help inform future intervention development in this population.</p>