Chronic kidney disease (CKD) is a progressive condition characterized by the gradual loss of kidney function, affecting 10% of the global population, with 850 million people affected, predominantly in low- and middle-income countries. Key risk factors include age, hypertension, diabetes, obesity, proteinuria, and environmental factors like salt intake and pollution. Age is the most significant non-modifiable risk factor, while hypertension, salt intake, obesity, and sympathetic overactivity are modifiable factors that can be targeted to slow CKD progression. Aging increases CKD risk due to physiological changes such as reduced renal mass, impaired blood flow, and increased oxidative stress. Older adults are at higher risk of end-stage renal disease (ESKD), with dialysis rates rising sharply after age 65. Managing modifiable risk factors is crucial for improving outcomes, optimizing resource use, and reducing mortality. Hypertension and high salt intake exacerbate CKD by increasing glomerular pressure and promoting fibrosis. Dietary sodium restriction has been shown to reduce blood pressure, proteinuria, and extracellular volume in CKD patients. The Mediterranean diet, rich in vegetables, fruits, and whole grains, is beneficial for CKD patients, reducing sodium, potassium, and phosphorus levels. Obesity is a major risk factor for CKD, with higher BMI correlating with increased CKD risk. Visceral fat contributes to inflammation and fibrosis, while weight loss can improve kidney function. Insulin resistance and sympathetic overactivity further worsen CKD by increasing glomerular pressure and promoting renal damage. Sympathetic overactivity, marked by increased norepinephrine, exacerbates CKD through hemodynamic and inflammatory mechanisms. Beta-blockers and renal denervation are potential therapeutic approaches to reduce sympathetic activity and slow CKD progression. In conclusion, addressing modifiable risk factors such as weight management, blood pressure control, and sodium restriction is essential for preventing or slowing CKD progression. A multifactorial approach targeting these factors is crucial for improving outcomes and reducing cardiovascular complications in CKD patients.Chronic kidney disease (CKD) is a progressive condition characterized by the gradual loss of kidney function, affecting 10% of the global population, with 850 million people affected, predominantly in low- and middle-income countries. Key risk factors include age, hypertension, diabetes, obesity, proteinuria, and environmental factors like salt intake and pollution. Age is the most significant non-modifiable risk factor, while hypertension, salt intake, obesity, and sympathetic overactivity are modifiable factors that can be targeted to slow CKD progression. Aging increases CKD risk due to physiological changes such as reduced renal mass, impaired blood flow, and increased oxidative stress. Older adults are at higher risk of end-stage renal disease (ESKD), with dialysis rates rising sharply after age 65. Managing modifiable risk factors is crucial for improving outcomes, optimizing resource use, and reducing mortality. Hypertension and high salt intake exacerbate CKD by increasing glomerular pressure and promoting fibrosis. Dietary sodium restriction has been shown to reduce blood pressure, proteinuria, and extracellular volume in CKD patients. The Mediterranean diet, rich in vegetables, fruits, and whole grains, is beneficial for CKD patients, reducing sodium, potassium, and phosphorus levels. Obesity is a major risk factor for CKD, with higher BMI correlating with increased CKD risk. Visceral fat contributes to inflammation and fibrosis, while weight loss can improve kidney function. Insulin resistance and sympathetic overactivity further worsen CKD by increasing glomerular pressure and promoting renal damage. Sympathetic overactivity, marked by increased norepinephrine, exacerbates CKD through hemodynamic and inflammatory mechanisms. Beta-blockers and renal denervation are potential therapeutic approaches to reduce sympathetic activity and slow CKD progression. In conclusion, addressing modifiable risk factors such as weight management, blood pressure control, and sodium restriction is essential for preventing or slowing CKD progression. A multifactorial approach targeting these factors is crucial for improving outcomes and reducing cardiovascular complications in CKD patients.