Chronic kidney disease (CKD), including pediatric CKD, is a global public health concern. Pediatric CKD has lasting effects into adulthood. In this review, we focus on the etiology of pediatric CKD and unique aspects that should be considered in treating a child with CKD, such as ensuring adequate nutrition and assessing growth hormone axis dysregulation. We review risk factors for CKD progression and how clinical surveillance can be used to address modifiable factors. We address the issues of accurate glomerular filtration rate (GFR) estimation, cardiovascular disease, immunization, neurodevelopment, and planned transition to adult care. We also cover kidney failure preparation and global CKD care disparities affecting children worldwide.