【Abstract】Patients with chronic kidney disease (CKD) are frequently afflicted with neurological complications. Among those, cognitive impairment (CI) is common and negatively affects health-related quality of life and other health-related outcomes. While the pathophysiology and etiology are complex and far from completely understood, CI may relate with vascular injury and some non-conventional cardiovascular risk factors. Some other non- conventional risk factors caused by ESRD, like anemia, oxidative stress, homocysteinemia and microinflammation, may aggravate the CI. In addition, hemodialysis and peritoneal dialysis may impact the brain by various mechanisms.