Abstract: Cognitive function decline is a common and often overlooked complication of chronic kidney disease (CKD), and its causes may include the accumulation of uremic toxins, disruption of the blood-brain barrier, as well as perturbations in metabolic and endocrine pathways. Dysbiosis of the gut microbiota is highly prevalent among CKD patients and is one of the important reasons for the increased production of uremic toxins. Moreover, the gut microbiota regulates the local and systemic levels of various metabolites, which can affect intestinal function, autonomic nervous system activity, and brain function. These metabolites impact multiple key processes such as blood-brain barrier integrity, formation of nerve myelin and survival/proliferation of nerve cells, appetite, metabolism, and thermoregulation, emotions, anxiety and depression. As mentioned in this article, dysbiosis of the gut microbiota can inversely regulate brain function and cognitive processes. Therefore, the gut microbiota may be involved in mediating cognitive function decline in CKD patients and may potentially serve as a promising target for clinical treatment through dietary intervention, prebiotics, and probiotics.

Key words: chronic kidney disease, gut microbiota, cognitive function