Cerebrovascular diseases (CVD) constitute important sequelae of advanced chronic kidney disease (CKD).1 Cerebral small vessel disease (CSVD), characterized by microvascular damage within the brain’s white matter, emerged as a precursor and reliable predictor of stroke, cognitive decline, and dementia.2 While recent studies described magnetic resonance imaging (MRI) markers of CSVD in combination with neurodegeneration in CKD, the independent association of CSVD to CKD in early stages remains unclear.