BACKGROUND & METHOD: The aim of this study is to study prevalence of cognitive function impairment in ckd patients in india & to study effect on cognitive function after hemodialysis initiation in ckd stage v patients. 65 patients from department of Nephrology Pushpawati Singhania Research Institute, New Delhi , who were CKD Stage III – V (eGFR < 60 ml/min/1.73m2 ), & were not on Hemodialysis and those End Stage Renal Disease patients in whom hemodialysis was initiated. RESULT: Result of both the group was statically significant, showing improvement in cognitive dysfunction after hemodialysis initiation. P vaue by both HMMSE and HMOCA score was less than 0.05. CONCLUSION: Our study also emphasizes on the fact that with the increasing CKD population there are more chances of cognitive dysfunction. Early evaluation of cognitive impairment in these patients is important because it affects the quality of life and adding life to years is adding years to life.