Introduction: The central nervous system (CNS) is commonly impacted in uremics and has been studied in these individuals in many ways. Various theories about the origin of central nervous systemtract lesions in chronic renal failure have been proposed from time to time. In the majority of studies, urea has been implicated. Hemodialysis patients are at high risk of cognitive impairment due to their older age and high prevalence of stroke and cardiovascular risk factors.