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Notably, both the renal and cerebral microcirculations share common characteristics of high flow and low resistance ( Indeed, the manifestations of cerebral small vessel disease (cSVD), including lacunar infarcts, white matter hyperintensities (WMH), and brain atrophy, bear similarities to diabetic microvascular complications, such as DKD ( 2.2 Renin-angiotensin-aldosterone system and cognitive impairment The brain renin-angiotensin-aldosterone system (RAAS) plays a vital role in neural function homeostasis and normal cognitive function, including memory, consolidation, and information retrieval ( Notably, enhanced activation of angiotensin II type 1 receptor by angiotensin II and the mineralocorticoid receptor by glucocorticoids and aldosterone can increase blood-brain barrier (BBB) permeability, induce oxidative stress, neuroinflammation, and astrocyte dysfunction ( Figure 2 ), while also decreasing cerebral blood flow ( Figure 2 3 The relationship between renal dysfunction and cognitive impairment 3.1 Correlation of renal damage with cognitive decline Chronic renal injury is primarily characterized by albuminuria and/or a low eGFR, and it is strongly linked to diabetes (31–33)