Abstract
Neurocognitive disorders are subclassified as major or mild based on whether activities of daily living are affected. Mild neurocognitive disorder is evidence of one or more cognitive deficits without loss of independent functioning. Cognitive impairment in chronic kidney disease is related to vascular and nonvascular mechanisms leading to microvascular injury, and white matter loss and microinfarction. Neurocognitive impairment is multifactorial in chronic kidney disease. End‐stage kidney disease and the actual process of dialysis can potentiate cerebral vascular changes including volume and electrolyte shifts and related dialysis disequilibrium. Cognitive testing is an important component of the clinical assessment to corroborate the history. There is little or no randomized controlled trial evidence for cognitive rehabilitation or remediation among children or adults with chronic kidney disease. Neurocognitive disorders in adults with chronic kidney disease alter decision‐making about dialysis treatment and reduce self‐care dialysis.