Chronic kidney disease (CKD) is associated with a high risk of cognitive impairment (CI). Both vascular and metabolic factors are implicated in the causation of CI in CKD. The traditional risk factors for CI are more prevalent in CKD and interact reciprocally. CI in CKD is associated with reduced functional capacity, poor quality of life and mortality. Cognition declines significantly after initiation of haemodialysis (HD). Repeated cerebral insults related to intra-dialytic haemodynamic instability may be responsible for the rapid, step-wise decline in cognition observed in HD patients. Cognitive interventions used in the general population have not been adequately tested in CKD. Exercise interventions are likely to be beneficial based on biological plausibility and pilot trial data. Cooled HD may be beneficial in HD patients but needs substantive trial data to support it. Cognition testing should be routinely offered to CKD patients. There is a need for further research into the underlying causes of CI in CKD with a view to developing therapeutic interventions.

慢性肾病 (CKD) 与认知障碍 (CI) 的高风险相关。血管和代谢因素都与 CKD 中 CI 的病因有关。CI 的传统危险因素在 CKD 中更为普遍，并且相互影响。CKD 中的 CI 与功能能力降低、生活质量差和死亡率相关。开始血液透析 (HD) 后，认知能力显着下降。与透析内血流动力学不稳定相关的反复脑损伤可能是 HD 患者认知能力快速、逐步下降的原因。一般人群中使用的认知干预措施尚未在 CKD 中得到充分测试。根据生物学合理性和试点试验数据，运动干预可能是有益的。冷却 HD 可能对 HD 患者有益，但需要大量试验数据来支持。应定期向 CKD 患者提供认知测试。需要进一步研究 CKD 中 CI 的根本原因，以制定治疗干预措施。