These CKD guidelines shifted the concept of kidney disease from that of an uncommon life-threatening condition requiring care by nephrologists to that of a common condition with a range of severity meriting attention by general internists, and demanding strategies for prevention, early detection, and management. Under-recognition of earlier stages of CKD and of risk factors for CKD, may partially explain the rising prevalence of treated ESRD. Increasing evidence accumulated in the past decades indicates that earlier stages of CKD can be detected through laboratory testing, and that therapeutic interventions implemented early in the course of CKD are effective in slowing or preventing the progression toward ESRD and its associated complications.