Chronic kidney disease has emerged as a public health problem of primary importance, mainly because of the high risk for coronary heart disease and other cardiovascular complications of this condition. Patients with end-stage renal disease are at a uniquely high risk for a severe form of the disease but most of the population burden generated by atherosclerotic complications derives from patients with moderate and severe degrees of kidney disease. A reduction in coronary heart disease and cardiovascular events as related to chronic kidney disease demands large-scale preventive measures targeting individuals with evidence of renal dysfunction, well before the end-stage renal disease phase.