Advancing Chronic Kidney Disease May be Linked to Cognitive Decline: Study Reveals

As chronic kidney disease worsens, the brain may quietly suffer alongside it. A new study suggests that advancing kidney dysfunction is linked to measurable declines in cognitive abilities-including attention, processing speed and executive function. The findings, published in JAMA Network Open, highlight disease severity as a potential risk factor for cognitive impairment.

Chronic kidney disease (CKD) is a long-term condition marked by the gradual loss of the kidneys’ ability to filter waste from the blood. It typically persists for more than three months and can progress over years. While CKD is known to increase cardiovascular risk, growing evidence suggests it may also affect brain health.

In this cohort study, researchers—including a team from Tulane University—analyzed data from 5,607 adults aged 21 to 79 with CKD. Participants underwent blood and urine testing to measure kidney function, along with standardized cognitive assessments over a six-year follow-up period. A key measure was the urinary protein-to-creatinine ratio, an indicator of kidney damage.

The results showed that higher levels of urinary protein were significantly associated with poorer performance in attention, processing speed and executive function—the mental skills involved in planning, organizing and decision-making. Even after adjusting for clinical factors such as hypertension, the association between kidney disease severity and cognitive decline remained.

Researchers suggest several possible mechanisms. CKD can worsen high blood pressure, which in turn may damage small blood vessels in the brain. Vascular injury is a well-known contributor to cognitive impairment and dementia. However, hypertension alone did not fully explain the observed link.

Other CKD-related conditions may also play a role. Chronic inflammation, oxidative stress, anemia, sleep disturbances and abnormal bone mineral metabolism—common in advanced kidney disease—have all been implicated in brain dysfunction in prior research.

The findings underscore the importance of monitoring cognitive health in patients with chronic kidney disease. As kidney function declines, clinicians may need to consider the brain as another organ at risk, emphasizing early intervention strategies that address both renal and cognitive health together.

REFERENCE: Huang Z, Yaffe K, Li C, et al. Chronic Kidney Disease Severity and Risk of Cognitive Impairment. JAMA Netw Open. 2026;9(2):e2559834. doi:10.1001/jamanetworkopen.2025.59834