Prebiotic, probiotic, and synbiotic intake have been shown to strengthen the immune system, reduce oxidative stress and inflammation, and improve blood lipid metabolism, factors that improve the prognosis of CKD. The consumption of tempeh can boost Bifidobacterium production, thereby providing probiotic benefits. This systematic review was obtained from the analysis and synthesis of the recent journals on PubMed, Science Direct, Nutrients, Clinical Key, and Google Scholar. Relevant studies were collected up to August 2024 using the following search terms: tempeh, probiotics, fermented soybeans, gut microbiota, and CKD. Patients with CKD experience gut microbiota dysbiosis and dysmetabolism, leading to the accumulation of gut microbiota-derived uremic toxins in the bloodstream. This contributes to increased susceptibility to infections, immunological disorders, and insulin resistance. Probiotic use has shown an inverse correlation with the urinary albumin-to-creatinine ratio (P < 0.05), a lower risk of CKD in subjects with hypertension, hyperlipidemia, and diabetes mellitus, and a significant reduction in high-sensitivity C-reactive protein (hs-CRP) levels. Probiotics aid in the metabolic processes that break down uremic toxins and reduce the risk of inflammation and oxidative stress. Tempeh serves as a probiotic source, potentially contributing to the enhancement of gut metabolism, reducing infection and inflammation risk, and delaying the progression of kidney failure in CKD patients. Further research is still needed regarding tempeh as a functional food, including the amount, processing, type of consumption and medication therapy.