Chronic kidney disease CKD has become an enormous worldwide health problem both in developed and less developed countries. The incidence and prevalence of CKD is high and is associated with increased mortality and morbidity. Of note CKD isampampnbspthe 12th most common primary cause of death accounting for about 1 million deaths per year worldwide.ampampnbspCKD and endstage renal disease are characterized by the progressive development of a series of complications such as anemia hyperkalemia hypervolemia mineral and bone disorders CKDMBD metabolic acidosis hyperuricemia and wasting all of these complications have been shown to be associated with adverse outcomes andampampnbspcan contribute either individually or in association to the cardiovascular morbidity and mortality observed in CKD.ampampnbspWhile at this time CKD progressionampampnbspis not treated with high efficacy new biomarkers of kidney fibrosis have become available in recent years andampampnbspnew treatments for kidney fibrosis and cell loss could become soon available.ampampnbspIn addition recent progress in our understanding of CKD pathophysiology together withampampnbspthe development of novel therapeutic agents has led to a renewed attention on the treatment of CKDassociated metabolic complications which are now are amenable to therapeutic interventions.