In addition to the loss of AChE activity and dendritic damages (as revealed in the present study), other factors which may contribute to the cognitive impairment in the CKD include hyperuricemia, hyperkalemia, hypercalcemia, anaemia, hyperparathyroidism, hyperhomocysteinemia, inflammation, and the traditional risk factors like endothelial dysfunction, vascular damages, diabetes, hypertension and silent brain infarct16–18,47,88–92, which are prevalent in rodent model of adenine-induced CKD as well51,56,59,60. Here, ACHE is linked to anemia.