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Essential for life, this is done by managing the transfer of solutes and water, getting rid of cellular waste, saving nutrients, and keeping the acid-base balance in the body in check. The kidney also makes three important hormones: erythropoietin, which helps make red blood cells, renin, which controls blood pressure, and calcitriol, which is the active form of vitamin D and helps control calcium levels in the blood. DEFINITION OF CHRONIC KIDNEY DISEASE (CKD) Some or all of your nephrons stop working when you have kidney disease. Chronic renal failure (CRF) has been replaced by the new name chronic kidney disease (CKD). In 2002, the National Kidney Foundation/Kidney Disease Quality Outcome Initiative (NKF/KDOQI) defined chronic kidney disease as structural damage or a GFR of less than 60 ml/min/1.73 m2 for more than three months. The NKF/KDOQI says that signs of kidney damage include pathological problems or signs of kidney damage, such as abnormal urine or blood tests or abnormal imaging tests (NKF/KDOQITM, 2002). With this new vocabulary, people who care for people with CKD all over the world can talk the same language. It also explains what CKD is and how people can be put into different groups (Levin, 2003). About 1.3 litres of blood pass through the kidneys' working parts, the nephrons, every minute. There, the blood is cleaned by a large number of capillary loops called glomeruli. In healthy kidneys, the filtration rate (GFR) is about 125 ml per minute. But things like diabetic nephropathy can make it drop so low that there is no more filtering. Table 1 shows that stages 2 through 5 of CKD start when the GFR is less than 90 ml per minute. When the GFR drops below 15 ml per minute, as it does in stage 5, the person needs help from outside to stay alive.