Chronic kidney disease (CKD) is a global problem that is currently three times more prevalent among African Americans, Hispanics, Pacific Islanders, American Indians, and people elderly (The National Kidney Foundation, 2013). CKD occurs when the kidneys are damaged by a pathogen or injury and can no longer properly maintain appropriate levels of regulated chemicals in the bloodstream. There are many risks associated with CKD. According to the National Kidney Foundation, two of the biggest risks are chronic kidney disease (CKD) and cardiovascular disease. Currently, twenty million American adults have CKD and millions more are at increased risk. Age has no barrier to chronic kidney disease. People with pre-existing health conditions and certain population groups are most likely to develop kidney disease. The main system involved in CKD is the urinary system; however, the respiratory, cardiovascular and digestive systems are unfortunately affected. This article will focus on the effects of CKD on the urinary system, with only brief introductions to other systems. Risk factors for CKD include diabetes; have high blood pressure; have a family history of kidney failure; are older; or belong to a population group with a high rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asians, Pacific Islanders, and American Indians (The National Kidney Foundation, 2013) . Kidney failure occurs when the kidneys do not work properly, causing uremia in the blood. Acute illness can appear quickly, but is often manageable. Acute illness can occur in three different states, called pre-, intra-, and post-renal insufficiency (Phillips, 2013). Pre-renal insufficiency develops...... middle of document......Encyclopedia of Nursing and Allied Health. (3rd ed.). (Vol.) 3. Detroit: Gale, 2013. 1888-1893. Gale Virtual Reference Library. Retrieved from http:www.gale.cengage.comPradeep, A. (2014). In V. Batuman (Ed.) Chronic kidney disease. Retrieved from http://emedicine.medscape.com/article/238798-overview#a0101 Saladin, K. S. (2012). Saladin Anatomy and Physiology 6th edition. Georgia: McGraw-HillHigher Education. Stevens, LA, Claybon, MA, Schmid, CH, Chen, J., Horio, M., Imai, E., Levey, AS (2011). Evaluation of the Chronic Kidney Disease Epidemiologic Collaborative Equation to Estimate Glomerular Filtration Rate in Multiple Ethnicities. Kidney International, 79(5), 555-62. doi:http://dx.doi.org/10.1038/ki.2010.462The National Kidney Foundation. (2013). About chronic kidney disease. Retrieved from http://www.kidney.org/kidneyDisease/aboutckd.cfm