The kidneys filter out wastes and water from the blood. Chronic kidney disease causes kidney function to worsen over time until dialysis is needed. Dialysis uses machines to filter the blood. Caring for kidney disease involves controlling diet, blood pressure, and medications to delay heart complications and the need for dialysis. Unfortunately, many patients do not know that they have chronic kidney disease and do not get care to delay complications. Risk factors include older age, family history of kidney disease, African-American ethnic background, diabetes, and high blood pressure. In 2002, the National Kidney Foundation developed recommendations for chronic kidney disease as part of an effort to improve quality of care. This article presents recommendations about the care of the early stages of chronic kidney disease.