The only possibility to reduce the constantly increasing number of patients qualified for renal replacement therapy is effective prevention of progression of chronic kidney disease (CKD) toward end-stage renal failure (ESRF). Apart from early diagnosis and treatment of primary factors causing kidney damage, multifactorial intervention is required consisting principally of: optimal glycaemic control in patients with diabetes and in all patients with CKD: good control of blood pressure, using drugs with nephroprotective properties, control of lipid disturbances, recommendation of adequate diet, treatment of obesity, disturbances of calcium-phosphate metabolism, anaemia, chronic inflammation and all other risk factors of atherosclerosis.