A recent study found that people living with chronic kidney disease (CKD) may have cognitive changes. These changes may be linked to the close connection between the kidneys, heart, and brain. Researchers also found that these effects may be different in men and women. The most important takeaway is that cognitive changes may be an underrecognized part of CKD.

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Understanding this connection may help people with CKD recognize symptoms earlier and talk with their healthcare team about protecting brain health.

Changes in Thinking May Be Common in CKD

Cognitive impairment, which can affect thinking, memory, and decision-making, may be more common in people with advanced CKD than many people realize.

Earlier research suggests that 30 percent to 60 percent of people with late-stage CKD may have cognitive impairment. This is about twice as common as in people without kidney disease.

Cognitive changes linked to CKD may affect several areas of thinking, including:

• Memory and recall
• Attention and concentration
• Language skills
• Problem-solving and decision-making

Other recent research has also linked worsening kidney function with a higher risk of cognitive impairment. In a study of more than 5,600 people with CKD, people with lower estimated glomerular filtration rate (eGFR) or higher levels of protein in the urine had a significantly greater risk of developing cognitive impairment over time.

Because these symptoms may develop gradually, they can sometimes be mistaken for normal aging or fatigue.

What the Study Found

The study included 112 adults over age 40, including people with advanced CKD and healthy adults for comparison. Researchers evaluated kidney function, cardiovascular health, and several blood markers linked to inflammation and neurodegeneration.

Participants also completed the Mini-Mental State Examination (MMSE). This is a commonly used screening test for cognitive function that evaluates memory, attention, language, and orientation.

Overall, people living with CKD had lower cognitive scores than participants without kidney disease.

The study also found that people with CKD had higher levels of biological markers linked to inflammation, heart disease, and neurodegeneration (loss of brain cells). These markers may help explain how kidney disease contributes to changes in brain function.

Differences Between Men and Women

The researchers also explored whether cognitive changes differed between men and women. Among participants with CKD, about 48 percent of men and around 20 percent of women showed cognitive impairment on testing. On average, women with CKD performed slightly better on overall cognitive tests than men.

However, the study found that certain markers associated with neurodegenerative diseases were more strongly linked to cognitive changes in women. These included tau proteins and amyloid-related markers, often studied in Alzheimer’s disease.

More research is needed to understand these differences and how they may affect future treatment or screening strategies.

Why These Findings Matter for People With Kidney Disease

Cognitive changes can affect daily life in many ways. People living with CKD may notice symptoms such as:

• Forgetting information more often
• Trouble concentrating
• Difficulty following conversations
• Slower decision-making or thinking

Researchers say recognizing these changes early could help healthcare professionals provide additional monitoring and support.

Importantly, this study was small, so larger studies are needed to confirm the results. For now, the main message is that kidney disease may affect more than kidney function alone. Being aware of these changes may help people with CKD get the support and care they need.

Talking with a healthcare provider about new or worsening changes in memory or thinking may help identify possible causes. Those conversations can also help determine whether additional screening or support is needed. Your care team can help evaluate symptoms, review medications, and discuss steps that may support both kidney and brain health.

Join the Conversation

On MyKidneyDiseaseTeam, people share their experiences with kidney disease, get advice, and find support from others who understand.

Have you noticed changes in your thinking or memory? Let others know in the comments below.