Although the diagnosis of CKD is now quite straightforward, the proportion of patients with end-stage renal disease encountered by nephrologists initially before the initiation of dialysis is still unacceptable. Early diagnosis and immediate nephrology referral are key steps in management as they enable predialysis education, allow implementation of preventive measures that delay or even halt the progression of CKD to end-stage renal disease, as well as decrease initial morbidity and mortality.