【Abstract】Objective To investigate the occurrence and mechanisms of the cognitive and depressive disorders in patients with chronic kidney disease (CKD). Methods According to glomerular filtration rate (eGFR) of the subjects, a total of 179 subjects were divided into healthy control group (eGFR＞90 ml/min/1.73m2), eGFR slight decrease group (30＜eGFR ＜60 ml/min/1.73 m2), and eGFR significant decrease group (eGFR<30 ml/min/1.73 m2). The Mini- mental State Examination (MMSE) and Self- rating Depression Scale (SDS) were used to evaluate the cognitive function and mental state of CKD patients. Brain MRI images were analyzed to calculate the rate of lacunar infarction and white matter demyelination. Results In eGFR slight decrease group and eGFR significant decrease group, the MMSE scores were 26.53±0.41 (c2=3.046, P=0.003) and 23.47±0.94 (c2=6.000, P＜0.000) respectively, and the SDS scores were 39.18±1.55 (c2=2.098, P=0.033) and 45.6±1.93 (c2=9.183, P=0.002), statistically different from the scores in control group. In the patients with cognitive and depressive disorders in eGFR slight decrease group and eGFR significant decrease group, the rates of lacunar infarction were 42.5% (c2=4.482, P=0.034) and 52.5% (c2=10.474, P=0.001) respectively, and the rates of white matter demyelination were 50.0% (c2=4.842, P=0.028) and 65.0% (c2=6.983, P=0.013) respectively, statistically higher than the rates in patients without cognitive or depressive disorders in the two groups. Conclusions The risks for cognitive impairment and depressive disorder were higher in CKD patients, possibly relating to the presence of lacunar infarction and white matter demyelination in these patients.