Kidney disease occurs when the kidneys can no longer remove waste and excess fluid from the bloodstream normally. Acute kidney injury (AKI) has an abrupt onset and is often reversible with timely intervention. In contrast, chronic kidney disease (CKD) progresses gradually and is frequently irreversible, with severity ranging from mild dysfunction to kidney failure. People with kidney failure typically require dialysis or kidney transplantation to survive.Kidney disease causes substantial morbidity, disability, and premature mortality, in part because it causes and is caused by cardiovascular disease. The burden of kidney disease is rising in parallel with diabetes, hypertension and population ageing. Global inequities in access to testing, essential medications, health- care workers and kidney replacement therapies are a key global challenge and contribute to millions of preventable deaths each year.