Chronic kidney disease (CKD) is a prevalent systemic disorder associated with cognitive impairment affecting memory, executive function, and attention, reflecting a disruption of the kidney–brain axis.This narrative review synthesizes current evidence regarding the pathophysiological mechanisms underlying CKD-associated cognitive decline and evaluates the therapeutic potential of resveratrol as a neuroprotective strategy.Cognitive impairment in CKD arises from uremic toxin accumulation, chronic inflammation, oxidative stress, and cerebrovascular dysfunction, leading to disruption of the blood–brain barrier and impaired synaptic plasticity.