Perspective:

Chronic kidney disease (CKD) is chiefly defined by a reduction in glomerular filtration rate and increased urinary albumin excretion, and has been recognized as a major public health burden. CKD affects more than 10% of the population in many countries worldwide, and its causes are complex and include common diseases such as hypertension, metabolic syndrome, and diabetes, and various less common diseases that mainly affect the kidney. It should be noted that CKD predisposes to acute kidney injury and vice versa. Furthermore, even mild forms of kidney disease are associated with various adverse effects on body functions and an increased risk of mortality and cardiovascular morbidity. Genetic causes of specific forms of kidney disease and susceptibility to development of kidney disease in the context of other disorders are increasingly recognized. A multilevel interdisciplinary approach is indicated to address the public health burden of kidney disease. Irrespective of specific interventions, the recognition of patients with CKD and acute kidney injury as individuals with high risk in all health care settings is of utmost importance. The establishment and prospective assessment of large cohorts of carefully characterized patients with CKD will likely have an important role in unraveling distinct categories of kidney disease. If such approaches continue to be successful, the next major breakthrough in CKD will hopefully lead to effective halting of kidney disease and its adverse outcomes through specific interventions, and ultimately regeneration of kidney function.