presence of renal damage or a decreased functioning rate of glomerular.(GFR<60ml/min/1.73m2) for duration of 90 days or longerwith or without kidney damage.32 The glomerular filtration rate (GFR), which is most commonly estimated (eGFR) using equations that include serum creatinine concentration along with demographic data, is the most frequently used index of overall kidney function.33,34 This condition is frequently not associated with significant symptoms until the disease is far advanced or urinary abnormalities and is unrecognized in 80–90% of cases.35 CKD are at high risk for progress to ESRD, a condition requiring renal replacement therapy, i.e., dialysis or kidney transplantation, to keep the patient’s long-term survival.33,34 The definition of stages 1 and 2 CKD is based upon manifestations of renal damage, i.e., the presence of either micro- or macro-albuminuria, erythrocyturia, or abnormalities on renal ultrasound. Determination of the eGFR in these earlier stages is required only to differentiate between stages 1 and 2 (eGFR >90 or between 60–89 mL min−1 per 1.73 m−2 , respectively). These early stages of CKD are mostly asymptomatic i.e. the normal of kidney functions, but the possibility for advanced disease is significant. As kidney disease worsens, kidney function begins to deteriorate (stages 3 and 4 CKD). Eventually, kidney failure (stage 5 CKD) arises, and kidney replacement therapy is required. Stages 3, 4, and 5 are exclusively defined by GFR (eGFR 30–59, 15–29 or <15 ml min-1 per 1.73 m-2 respectively.)35 The K/DOQI chronic kidney disease staging system (Table 1) is based on GFR.32 Stages of CKD with their GFR values Risk factors for early chronic kidney disease: The following risk factors are associated with a significant (20–40%) risk of CRF: Obesity Hypertension Diabetes mellitus Cigarette smoking Established CVD Age > 60 years

Familial history of stage 5 CKD or hereditary kidney disease in a first or second degree relative

Severe socioeconomic disadvantage.

Presences of renal calculi (6% absolute risk)

Alcohol abuse and Benign prostatic hypertrophy.36

Most common complications and comorbidities of CRF include

Fluid and Electrolyte Abnormalities,

Anaemia,