Chronic kidney disease (CKD) is a worldwide problem that is currently three times higher for African Americans, Hispanics, Pacific Islanders, American Indians, and older adults (The National Kidney Foundation, 2013). Chronic kidney disease occurs when the kidneys are damaged by a pathogen or injury and can no longer adequately maintain adequate levels of regulated chemicals in the bloodstream. There are many risks associated with chronic kidney disease. According to the National Kidney Foundation, two of the biggest risks are chronic kidney disease (CKD) and cardiovascular disease. Twenty million American adults currently suffer from chronic kidney disease, and millions more are at increased risk. Age has no obstacle to the onset of chronic kidney disease. People with pre-existing health problems, and a portion of certain population groups, are most likely to develop kidney disease. The main system involved in chronic kidney disease is the urinary system; however the respiratory, cardiovascular and digestive systems are unfortunately negatively affected. This article will focus on the effects of chronic kidney disease on the urinary system, with only brief introductions to the other systems. Risk factors for chronic kidney disease include diabetes; have high blood pressure; have a family history of kidney failure; they are older; or belong to a population group that has a high rate of diabetes or hypertension, such as African Americans, Hispanic Americans, Asians, Pacific Islanders, and American Indians (The National Kidney Foundation, 2013). Kidney failure occurs when the kidneys fail to function properly causing uremia in the blood. The acute condition may begin quickly, but is often still manageable. The acute condition can occur in three different states, called pre-, intra- and post-renal failure (Phillips, 2013). Pre-renal failure develops… half 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.com Pradeep, A. (2014). In V. Batuman (ed.) Chronic kidney disease. Retrieved from http://emedicine.medscape.com/article/238798-overview#a0101Saladin, K. S. (2012). Saladin Anatomy and Physiology 6th edition. Georgia: McGraw-Hill Higher Education.Stevens, L.A., Claybon, MA, Schmid, C.H., Chen, J., Horio, M., Imai, E., Levey, A.S.(2011). Evaluation of the chronic kidney disease epidemiological collaboration equation for estimating glomerular filtration rate across multiple ethnicities. Kidney International, 79(5), 555-62. doi: http://dx.doi.org/10.1038/ki.2010.462 National Kidney Foundation. (2013). Chronic kidney disease information. Retrieved from http://www.kidney.org/kidneyDisease/aboutckd.cfm