In recent years there has been a keen interest in the neurocognitive sequelae of renal failure and subsequent end-stage renal disease given its increasing prevalence and incidence. This review article summarizes the relevant information on cognitive functioning in chronic kidney disease in adults before the initiation of dialysis, after the initiation of dialysis, and after renal transplantation. In general, compared to pre-dialysis, there is an improvement in cognitive function after the institution of dialysis and further improvement after renal transplantation. Throughout the paper an attempt is made to highlight the importance of considering disease related variables in the neuropsychological assessment of individuals with chronic kidney disease. The paper concludes with a discussion of future avenues of research.